Name These Guidelines
These guidelines would be used to further evaluate abnormalities found on mammogram.
What are BR-1.1 and BR-5.1?
What is considered the initial imaging(s) for breast pain
What are mammogram and ultrasound (BR-7.1)?
To evaluate or confirm breast implant rupture initial imaging is based on?
What is PE findings, age and implant type? (BR-5.1)
One of these four risk estimator models can be used when the CR is reviewing a case for high risk screening for Breast MRI.
What is Gail(NCI), Claus, Tyrer-Cuzick (IBIS) or BRCAPRO? (BR-5.1)
What is the most appropriate CPT code when reviewing an MRI breast anytime they are evaluating breast tissue (with the exception of a health plan rule)?
What is CPT code 77049 MRI breast bilateral with and without contrast (or C8908 is health plan allows)
Which guideline is correct for: Radiologist Report Recommendation for MRI Breast to assess inconclusive or conflicting findings on mammography or ultrasound that are not associated with a discrete palpable mass.
What is BR-5.1?
Prior to sending a breast imaging request to the MD for review the CR should check this resource.
What are the State Specific Mandates?
For BI-RADS 3 lesions, the original study is repeated at 6 months. If imaging remains at a BI-RADS 3, the original study can be repeated at ______, ______ and _____ months from the date of initial imaging.
What is 12, 18 and 24 (BR-1.1, BR-5.1)?
For a client with two or more first degree relatives with breast cancer, the youngest age of diagnosis being age 37, annual Breast MRI screening would begin at age ___.
What is 27? (BR-5.1)
This CPT code should be used initially to evaluate a palpable breast mass or other clinical finding (such as skin change, pain, nipple inversion).
What is breast ultrasound CPT 76641 or 76642? (BR-1.1)
Which guideline would be used to review a follow up MRI breast bilat wwo after a benign finding on an prior MRI guided breast biopsy.
What are BR-5.1?
These studies are considered the initial imaging to evaluate pathologic nipple discharge.
What is Diagnostic Mammogram and Breast Ultrasound? (BR-6.1)
Should BI-RADS 3 follow up imaging become a BI-RADS 1 or 2 finding, imaging reverts to this.
What is routine per individuals risk profile (BR-1.1, BR-5.1)?
MRI Breast surveillance (annual) is not indicated for patients with a high-risk indication after this?
Bilateral Mastectomy? (BR-5.1)
These CPT code(s) can be used as a preoperative planning for breast reconstruction
What is CTA Abdomen and/or Pelvis (CPT 74175 or CPT 72191 or CPT 74174) or MRA Abdomen and/or Pelvis (CPT 74185 and/or CPT 72198)
Molecular breast imaging (MBI) is found in which guideline.
What is BR-8.1?
This imaging study can be used to evaluate women with clinically suspicious axillary lymph nodes
What is axilla ultrasound (CPT 76882)? (BR-1.1)
Further diagnostic pathway for suspicious clinical or imaging findings in males with suspected breast cancer usually requires this.
What is tissue diagnosis? (BR-9.1)
MRI screening to begin at diagnosis but not prior to age 25 for a client with a history of _____. (Hint: three answers-cell types)
What are Atypical ductal hyperplasia (ADH), Atypical lobular hyperplasia (ALH) or Lobular carcinoma in situ (LCIS)? (BR-5)
The use of these two CPT codes in conjunction with MRI Breast is not necessary since the CAD software automatically performs 3D imaging.
What is 3D Rendering CPT 76376 and CPT 76377? (BR-2.1)
Which guideline would you find a CTA or MRA of the abdomen and/or pelvis prior to surgical planning for a free tissue transfer flap.
What is BR-3.1?
Prior to consideration of advanced imaging a BI-RADS 4 or 5 lesion on mammogram and/or ultrasound should have _____?
What is a biopsy? (BR-5.1)
For pathologic nipple discharge, this study can be done if both the diagnostic mammogram and US are negative or inconclusive.
What is a MRI Breast bilat wwo(BR-6.1)?
Breast screening should start 8-10 years post therapy or at age 25, whichever comes first if the member has this type of history.
What is history of radiation to the chest between ages 10 and 30? (BR-5.1)
This CPT code is the correct coding for an MRI guided breast biopsy and is NOT reviewed by eviCore
What is CPT code(s) 19805 and 19806 (MRI guided breast biopsy)? (BR-2.1)