Bilateral Ultrasound of Breast: CPT Code and What to Expect
Choosing the right healthcare provider and understanding the billing process can be confusing. This guide breaks down the CPT code for a bilateral breast ultrasound and explains what you can expect during the procedure. We'll also address some frequently asked questions surrounding this common imaging technique.
Understanding CPT Codes: CPT (Current Procedural Terminology) codes are standardized numeric codes used to describe medical, surgical, and diagnostic services. Insurance companies and healthcare providers utilize these codes for billing and reimbursement. Knowing the correct CPT code is crucial for accurate billing and claim processing.
The CPT Code for Bilateral Breast Ultrasound: The CPT code for a bilateral breast ultrasound is 76072. This code specifically covers a complete ultrasound examination of both breasts. It's important to note that additional codes may be applied if additional services or procedures are performed, such as a biopsy guided by ultrasound.
What Happens During a Bilateral Breast Ultrasound?
A bilateral breast ultrasound is a non-invasive imaging test that uses high-frequency sound waves to create images of the breast tissue. The procedure is generally painless and takes about 30-45 minutes. During the exam, a technician will apply a lubricating gel to your skin and move a transducer (a small handheld device) over your breasts. The sound waves reflect off the tissue, creating images that are displayed on a monitor. The radiologist or sonographer will examine these images to look for abnormalities such as cysts, masses, or other suspicious areas.
What are the reasons for a bilateral breast ultrasound?
A bilateral breast ultrasound may be ordered for several reasons, including:
- Screening: As part of routine breast cancer screening, particularly for women with dense breast tissue where mammograms may not be as effective.
- Diagnostic evaluation: To further investigate findings from a mammogram or physical exam, such as a palpable lump or an area of concern.
- Guidance for biopsies: To guide the needle during a breast biopsy.
- Monitoring: To monitor the size and characteristics of pre-existing cysts or masses.
- Follow up after treatment: To assess treatment response after breast surgery or radiation therapy.
What if something abnormal is found?
If the ultrasound reveals an abnormality, your doctor may recommend further testing, such as a mammogram, MRI, or breast biopsy to determine if the abnormality is cancerous. The radiologist will provide a report to your doctor detailing the findings of the ultrasound. It's crucial to follow up with your doctor to discuss the results and any recommended next steps.
What are the potential risks and side effects?
Bilateral breast ultrasounds are generally considered safe and have very few risks or side effects. In rare cases, some patients may experience mild discomfort or bruising at the site where the gel was applied.
How much does a bilateral breast ultrasound cost?
The cost of a bilateral breast ultrasound can vary depending on several factors, including your location, the specific healthcare facility, and your insurance coverage. It’s always recommended to check with your insurance provider and the facility beforehand to understand the anticipated cost.
Do I need a referral for a bilateral breast ultrasound?
Whether or not you need a referral depends on your insurance plan and your doctor's recommendations. Some insurance plans may require a referral from your primary care physician or another specialist before covering the cost of the ultrasound. It’s essential to contact your insurance provider to determine their specific requirements.
This information is for educational purposes only and should not be considered medical advice. Always consult with your doctor or healthcare provider for any questions or concerns about your health. They can provide personalized advice based on your individual medical history and situation.
