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Name of the Procedure:
Screening, Diagnostic, Film, Digital or Digital Breast Tomosynthesis (3D) Mammography Results Documented and Reviewed (HCPCS Code: G9899).
Summary
A mammogram is an X-ray exam of the breast used to screen for or diagnose breast cancer. It can be done using traditional film, digital technology, or three-dimensional (3D) imaging known as breast tomosynthesis.
Purpose
The main purpose of a mammogram is to detect early signs of breast cancer, often before a patient experiences any symptoms. This early detection significantly increases the chances of successful treatment and can save lives.
Indications
- Routine screening for breast cancer in women, typically over the age of 40.
- Investigate lumps, pain, nipple discharge, or changes in breast size or shape.
- Follow-up on abnormal findings from a physical exam or previous mammogram.
Preparation
- Avoid using deodorants, perfumes, or lotions under the arms or on the breast area, as these can interfere with the imaging.
- Wear a two-piece outfit so you only need to undress from the waist up.
- Inform your healthcare provider if you are pregnant or breastfeeding.
- Bring previous mammogram images for comparison, if available.
Procedure Description
- Check-In: The patient checks in and is taken to a private room.
- Undress from Waist Up: The patient removes clothing from the waist up and wears a provided gown.
- Positioning: A technologist positions the patient's breast on the mammogram machine. The breast is compressed between two plates to spread the tissue for clearer images.
- Imaging: X-ray images are taken from different angles. For 3D mammography, multiple images are captured to create a 3D picture of the breast.
- Review: A radiologist reviews the images for any signs of abnormality.
Duration
The entire procedure typically takes about 20-30 minutes, with the actual imaging taking only about 5 minutes.
Setting
Mammograms are performed in hospitals, outpatient radiology clinics, or specialized breast imaging centers.
Personnel
- Radiologic Technologist: Operates the mammogram machine and positions the patient.
- Radiologist: Specialist who analyzes the mammogram images and provides a diagnostic report.
Risks and Complications
- Common Risks: Mild discomfort or pain from breast compression, exposure to low-dose radiation.
- Rare Risks: Anxiety from abnormal results, need for additional testing, false positives or negatives.
Benefits
- Early Detection: Identifies breast cancer at an early stage when treatment is most effective.
- Screening and Diagnosis: Helps differentiate between benign and malignant conditions.
- Quick Results: Most facilities provide results within a few days, accelerating timely medical actions.
Recovery
- Immediate Recovery: No recovery time needed; you can resume normal activities immediately.
- Follow-Up Care: Follow-up appointments if abnormalities are detected for further testing or treatment.
Alternatives
- Breast Ultrasound: Uses sound waves to create images of the breast; often used as a follow-up to a mammogram.
- MRI: Magnetic resonance imaging for more detailed images; used for high-risk patients.
- Clinical Breast Exam: Physical examination by a healthcare provider.
Patient Experience
- During the Procedure: You may feel discomfort from the pressure applied to your breasts, but it lasts only a few seconds for each image.
- After the Procedure: Most women experience mild or no pain after the mammogram. Any discomfort usually subsides quickly.
Pain management is typically not necessary, but over-the-counter pain relief can be used if needed for any lingering discomfort.
G9899 policy automation walkthrough
Walk through the policies, prior authorization requirements, and workflow automation opportunities connected to this code.