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Digital Breast Tomosynthesis (DBT) System

Conclusion
This year has definitely been a challenging one for the coding and billing of breast imaging. As acceptance of tomosynthesis continues to grow in the industry, we should see commercial payers begin to publish policies that allow for coverage and reimbursement. Radiology is not a clinically stagnant specialty, which means that we will continue to see new codes, new guidance, and hopefully additional reimbursement.

“Digital breast tomosynthesis improves sensitivity and specificity,” Smetherman says.

Like other breast imaging modalities, tomosynthesis use will evolve as users learn more about best practices and the reimbursement process matures.
“In the end, DBT is a better mammogram for the patient,” Destounis says. “It’s great that we have this available to use with our patients, but we have to work through all the issues.”

Digital Breast Tomosynthesis - Giotto Class

7/1/2014.2015 Reimbursement Information for Mammography, CAD and Digital Breast Tomosynthesis.

*President, MedCom Consultants Inc, Potomac, Maryland. Address correspondence to: Steven Marks, MedCom Consultants Inc, 1311 Fallsmead Way, Potomac, Maryland, 20854. Email: . Disclosure statement: The author reports having no financial or advisory relationship with any corporate, medical, or political organization doing work related to this paper or other business activity at MedCom Consultants, Inc. ABSTRACT Breast cancer is the most frequently diagnosed cancer in women and is the second leading cause of cancer-related death. Mammography is recognized as the preferred methodology for detecting and evaluating patients with early stage breast cancer, however, it has a low positive predictive value. As a result, a high percentage of recalls for further imaging or biopsy do not yield higher rates of cancer detection. In fact, additional testing can place a substantial psychological and cost burden on patients and the healthcare system. By generating a 3-dimensional image of the breast tissue during standard mammographic compression, digital breast tomosynthesis (DBT) has been shown to reduce the noise from overlapping and superimposed breast tissue. In so doing, DBT has the potential to overcome the limits of mammography. Studies have shown that DBT is a highly cost-effective imaging technology in screening and diagnostic populations compared with full-field digital mammography, and as a result, advanced applications are now under investigation. Recent approvals of DBT by the US Food and Drug Administration and the Centers for Medicaid and Medicare Services for reimbursement have led to its increasing adoption by clinicians, and DBT also has found favor with women. The standard approaches to utilization and the most appropriate applications for clinical use are still being determined.

One of the new procedure codes is designated for screening services. When tomosynthesis is performed in conjunction with a regular screening mammogram (77057 or G0202), the new add-on code 77063 (screening digital breast tomosynthesis [DBT], bilateral [list separately in addition to code for primary procedure]) should be reported. The CPT manual indicates that 77063 should not be reported together with the regular 3D rendering codes 76376/76377, or the regular diagnostic mammography codes 77055/77056. Medicare does provide coverage for screening tomosynthesis, but most other payers consider this service to be investigational and will not provide separate payment at this time. As a result, it is important that coders remain current on the policy of top payers regarding tomosynthesis.

Digital Breast Tomosynthesis: The State of the Science …

Breast cancer screening using tomosynthesis in combination with digital mammography.

With two-dimensional mammography, overlapping tissue can mask suspicious areas. Since thin layers of breast tissue are viewed with DBT, the overlap is removed and abnormalities are much easier to recognize. Studies have shown improved tissue identification, improved tumor visualization, and a lower recall rate for additional testing. Because of this, digital breast tomosynthesis has the potential to improve on the accuracy of mammography.

Digital breast tomosynthesis (DBT) is becoming increasingly popular in healthcare, but there are still many uncertainties surrounding it. Below are common questions healthcare organizations are asking about DBT and it is my goal to provide as thorough and accurate of answers as possible to demonstrate this technology’s value.

“We bill using the new codes but digital breast tomosynthesis is still not being covered,” she says. “It’s still seen as investigative.”
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Subject: Digital Breast Tomosynthesis - Florida Blue

The caveat of offering DBT to all patients, however, is that Allegheny also gives patients a card stating that while this 3D technology is beneficial in the early detection of breast cancer, the patient may be responsible for the cost. Poller says that a lack of reimbursement could be one of the reasons why he has seen a decrease in tomosynthesis volume.

Digital breast tomosynthesis ..

Destounis says that a lack of reimbursement hasn’t stopped her practice from using DBT, particularly in cases of women with dense breasts and other high risk factors for breast cancer, including patients with personal history of breast cancer. In addition, she says DBT can be helpful in viewing a lumpectomy scar and areas of postsurgical change that may be challenging with standard full-field digital mammography.

Q&A: Digital Breast Tomosynthesis - Everything Rad

At the request of professional organizations such as the American Roentgen Ray Society, RSNA, and the ACR, the American Medical Association’s CPT Editorial Panel created three new codes to describe the physician work and practice expense associated with screening and diagnostic DBT. However, CMS recommends that only one code (77063, screening digital breast tomosynthesis, bilateral) be used as this time, in conjunction with the digital screening mammography code. This recommendation is based on an FDA requirement that a 2D mammogram accompany DBT when used for screening purposes.

Digital breast tomosynthesis reimbursement | scholarly …

“I thought that when reimbursement was approved for digital breast tomosynthesis insurance companies would pay for it and with that, more practices would adopt this technology,” says Jaime Geisel, MD, an assistant professor of diagnostic radiology at the Yale University School of Medicine. “Tomosynthesis is the most dramatic change we’ve had recently in breast imaging and is an incredible thing for women.”

, also known as digital breast tomosynthesis, ..

Since FDA approval in 2011 of Hologic’s Selenia Dimensions system, the United States has seen two more 3D mammography options enter the market. GE Healthcare’s breast tomosynthesis solution, called SenoClaire, received FDA approval in 2014. Siemens Healthcare’s offering, approved this year for use in the United States, is a breast tomosynthesis add-on option for the company’s MAMMOMAT Inspiration digital mammography platform.

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