Ge elastography cpt codes Aetna considers digital mammography a medically necessary acceptable alternative to film mammography. Currently, there are no guideline recommendations from leading medical professional organizations to screen men at risk for hereditary breast cancer with mammography. Robson (2002) explained "There are no established guidelines for screening of men at risk for hereditary breast cancer. It is reasonable to suggest periodic self-examination and evaluation by a provider experienced in clinical breast examination. The utility of screening mammography in men is unknown, although it is technically possible in at least some individuals." However, diagnostic mammography may be indicated in men with a breast mass on clinical examination (American Cancer Society, 2003). Aetna considers screening mammography for men experimental and investigational, as the clinical benefits of such screening in men are unproven. Current guidelines from the U.S. Preventive Services Task Force and the American College of Radiology recommend such screening only for women. Aetna considers mammography medically necessary for surveillance of men with a prior history of breast cancer. clinical breast examination (CBE) beyond screening mammography in women aged 40 years or older, and. CPB 0105 - Magnetic Resonance Imaging (MRI) of the Breast;. The U.S. Preventive Services Task Force (USPSTF) revised their recommendations for mammography screening in 2009. Whereas they had formerly recommended routine screening every 1 to 2 years starting at age 40, they now recommend against routine screening for women aged 40 to 49 and biennial rather than annual screening for women aged 50 to 74. In their 2009 recommendations, the USPSTF recommend that women aged 40 to 49 consider their personal risk for developing breast cancer before deciding to participate in regular, biennial screening. The USPSTF concluded that the current evidence is insufficient to assess the additional benefits and harms of. Women who meet criteria for BRCA mutation testing in CPB 227 - BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy; or. screening mammography in women aged 75 years or older,. Women with diagnosis of, or has first-degree relative with, one or more of the following:. Screening mammography aims to reduce morbidity and mortality from breast cancer by early detection and treatment of occult malignancies. There is extensive evidence from a variety of well-conducted, randomized controlled studies that annual or biennial mammography is effective in reducing breast cancer mortality by 30 % in women aged 50 to 69 years. Data on women under age 50 are less clear. Results from the Canadian National Breast Screening Study (CNBSS) suggest that the contribution of mammography over good physical examinations to breast cancer mortality reduction may be less than has been assumed. This observation re-emphasizes a truism of screening -- that it is not necessary to detect cancers as early as possible to obtain a benefit -- it is only necessary to detect them early enough. What is early enough in any individual case is uncertain because there are insufficient outcomes data. This has made it difficult for
professional societies to develop specific mammography screening recommendations for high-risk women. In addition, the USPSTF recommended against clinicians teaching women how to perform breast self-examination. On behalf of the USPSTF, Siu (2016) updated the 2009 USPSTF recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following: effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiation-induced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have pre-existing breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. Personal history of radiation to chest between ages 10 and 30 years. Note: Diagnostic mammography is covered regardless of whether the member has preventive services benefits. Berg et al (2008) compared the diagnostic yield, defined as the proportion of women with positive screen test results and positive reference standard, and performance of screening with ultrasound plus mammography versus mammography alone in women at elevated risk of breast cancer. A total of 2,809 women, with at least heterogeneously dense breast tissue in at least 1 quadrant, were recruited from 21 sites to undergo mammographic and physicianperformed ultrasonographic examinations in randomized order by a radiologist masked to the other examination results. Reference standard was defined as a combination of pathology and 12-month follow-up and was available for 2,637 (96.8 %) of the 2,725 eligible participants. Main outcome measures included diagnostic yield, sensitivity, specificity, and diagnostic accuracy (assessed by the area under the receiver operating characteristic curve) of combined mammography plus ultrasound versus mammography alone and the positive predictive value of biopsy recommendations for mammography plus ultrasound versus mammography alone. A total of 40 participants (41 breasts) were diagnosed with cancer: 8 suspicious on both ultrasound and mammography, 12 on ultrasound alone, 12 on mammography alone, and 8 participants (9 breasts) on neither. The diagnostic yield for mammography was 7.6 per 1,000 women screened (20 of 2,637) and increased to 11.8 per 1,000 (31 of 2,637) for combined mammography plus ultrasound; the supplemental yield was 4.2 per 1,000 women screened (95 % confidence interval [CI]: 1.1 to 7.2 per 1,000; p = 0.003 that supplemental yield is 0). The diagnostic accuracy for mammography was 0.78 (95 % CI: 0.67 to 0.87) and increased to 0.91 (95 % CI: 0.84 to 0.96) for mammography plus ultrasound (p = 0.003 that difference is 0). Of 12 supplemental cancers detected by ultrasound alone, 11 (92 %) were invasive with a median size of 10 mm (range of 5 to 40 mm; mean [SE], 12.6 [3.0] mm) and 8 of the 9 lesions (89 %) reported had negative nodes. The positive predictive value of biops. Aetna considers contrast-enhanced spectral mammography experimental and investigational because of insufficient evidence of its effectiveness. Aetna considers annual mammography screening a medically necessary preventive service for women aged 40 and older. Annual mammography is also
considered medically necessary for younger women who are judged to be at high-risk including: The USPSTF concludes that the current evidence is insufficient to assess the benefits and harms of digital breast tomosynthesis (DBT) as a primary screening method for breast cancer (I statement). Aetna considers computer-aided detection (CAD) a medically necessary adjunct to mammography. With screen-film mammography, 2D X-ray images of the breasts are recorded onto photographic film. Each breast is positioned and compressed between two clear plates, which are attached to a specialized camera, and pictures are taken from two directions. Poller et al (2012) stated that annual ultrasound screening may detect small, node-negative breast cancers that are not seen on mammography; and magnetic resonance imaging (MRI) may reveal additional breast cancers missed by both mammography and ultrasound screening. These researchers examined supplemental cancer detection yield of ultrasound and MRI in women at elevated risk for breast cancer. From April 2004 to February 2006, a total of 2,809 women at 21 sites with elevated cancer risk and dense breasts consented to 3 annual independent screens with mammography and ultrasound in randomized order. After 3 rounds of both screenings, 612 of 703 women who chose to undergo an MRI had complete data. The reference standard was defined as a combination of pathology (biopsy results that showed in-situ or infiltrating ductal carcinoma or infiltrating lobular carcinoma in the breast or axillary lymph nodes) and 12-month follow-up. Main outcome measures included cancer detection rate (yield), sensitivity, specificity, positive-predictive value (PPV) of biopsies performed and interval cancer rate. A total of 2,662 women underwent 7,473 mammogram and ultrasound screenings, 110 of whom had 111 breast cancer events: 33 detected by mammography only, 32 by ultrasound only, 26 by both, and 9 by MRI after mammography plus ultrasound; 11 were not detected by any imaging screen. Among 4,814 incidence screens in the 2nd and 3rd years combined, 75 women were diagnosed with cancer. Supplemental incidence-screening ultrasound identified 3.7 cancers per 1,000 screens (95 % CI: 2.1 to 5.8; p. Type in CPT code 77080, click on CPT search - no written policy. Click on Continue, click on Radiology, Click on Bone Mineral Density. click on search, select local, select state, select CPT 77080. For all other radiopharmaceuticals, please contact GE Healthcare Reimbursement Hotline @ 800 767 6664. Information you need to help improve outcomes for your patients, staff and your enterprise; including access to clinical, operational, leadership topics, and trends. Expanded access through MyGEHealthcare, our secure portal to help you operate more efficiently. Password Protected, may or may not have a written coverage policy. CIGNA Healthcare for Health Care Professionals - Coverage Positions. Health Insurance Offered by Anthem Blue Cross and Blue Shield. 1 Diagnostic Radiology, National University of Singapore, Singapore Find articles by Sudhakar K Venkatesh. The NCBI web site requires JavaScript to function. MyGEHealthcare. Insights and data to help you deliver improved outcomes for your patients and staff. Ultrasound LOGIQ E10: Empowering you to make the difference. Generating Elastograms After the acquisition is complete, the wave images are automatically processed by the scanner to generate images that depict tissue stiffnesscalled elastograms. Several different types of inversion algorithms have been used, including spatial frequency estimation, and analytic solutions to the wave equation ( 34, 35 ). These quantitatative images typically depict shear stiffness in units of kilopascals (kpa), and may be displayed in a gray scale or with a color scale ( 36 ) ( Fig 5 ). Early detection of fibrosis with MRE. Two patients with chronic hepatitis B. The patient in the upper row has normal liver stiffness, whereas the patient in the lower row has modestly elevated liver stiffness. Biopsies excluded fibrosis in the first patient and showed mild fibrosis in the
second. All conventional MR images were normal in both patients. J Magn Reson Imaging. Author manuscript; available in PMC 2014 Mar 1. Click on I Agree, Search by 77080 - currently no written coverage policy. Magnetic Resonance Elastography (MRE), Liver, Fibrosis, Technique, Analysis, Clinical applications. Enter your email address below and we will send you the reset instructions. GE Healthcare advocates for the timely patient access to medically appropriate, high quality imaging services, provided by knowledgeable and skilled providers of care. Studies comparing the MRE with Fibroscan are few ( 27, 47 ). In one study, MRE had a higher technical success rate than Fibroscan and a better diagnostic accuracy (0.994 for F > 2; 0.985 for F > 3; 0.998 for F > 4) than Fibroscan and aspartate aminotransferase to platelets ratio index (APRI), and the combination of Fibroscan and APRI (0.837, 0.709, and 0.849 for F > 2; 0.906, 0.816, and 0.936 for F > 3; 0.930, 0.820, and 0.944 for F > 4, respectively) ( 27 ). Enter your email address below and we will send you your username. Diagram showing typical positioning of the mechanical driver over the right lobe of the liver with its center approximately at the level of xiphisternum. The location is chosen so that the largest cross-section of the liver is directly under the passive driver to ensure good illumination of liver during breath holds at the end of expiration. Schematic showing a 2-D gradient echo-based MR elastography sequence. Sensitivity to cyclic tissue motion caused by wave propagation is achieved by adding motion encoding gradients (MEGs) that are synchronized with the applied vibration throughout image acquisition. The MEGs (shown in pink) can be applied to sensitize the sequence to cyclic tissue motion in the x, y, or z directions, as shown. The phase relationship (θ) between the MEGs and the applied waves can be adjusted in steps to acquire wave images at different phases of the cyclic motion. Poller et al (2012) stated that annual ultrasound screening may detect small, node-negative breast cancers that are not seen on mammography; and magnetic resonance imaging (MRI) may reveal additional breast cancers missed by both mammography and ultrasound screening. These researchers examined supplemental cancer detection yield of ultrasound and MRI in women at elevated risk for breast cancer. From April 2004 to February 2006, a total of 2,809 women at 21 sites with elevated cancer risk and dense breasts consented to 3 annual independent screens with mammography and ultrasound in randomized order. After 3 rounds of both screenings, 612 of 703 women who chose to undergo an MRI had complete data. The reference standard was defined as a combination of pathology (biopsy results that showed in-situ or infiltrating ductal carcinoma or infiltrating lobular carcinoma in the breast or axillary lymph nodes) and 12-month follow-up. Main outcome measures included cancer detection rate (yield), sensitivity, specificity, positive-predictive value (PPV) of biopsies performed and interval cancer rate. A total of 2,662 women underwent 7,473 mammogram and ultrasound screenings, 110 of whom had 111 breast cancer events: 33 detected by mammography only, 32 by ultrasound only, 26 by both, and 9 by MRI after mammography plus ultrasound; 11 were not detected by any imaging screen. Among 4,814 incidence screens in the 2nd and 3rd years combined, 75 women were diagnosed with cancer. Supplemental incidence-screening ultrasound identified 3.7 cancers per 1,000 screens (95 % CI: 2.1 to 5.8; p. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of adjunctive screening for breast cancer using breast ultrasonography, magnetic resonance imaging (MRI), DBT, or other methods in women identified to have dense breasts on an otherwise negative screening mammogram. (I statement). The USPSTF recommends biennial screening mammography for women aged 50 to 74 years (B recommendation). The decision to start screening mammography in women prior to age 50 years should be an individual one. Women who
place a higher value on the potential benefit than the potential harms may choose to begin biennial screening between the ages of 40 and 49 years (C recommendation). Personal history of radiation to chest between ages 10 and 30 years. A 1997 Consensus Development Panel convened by the National Institutes of Health concluded that the evidence was insufficient to determine the benefits of mammography among women aged 40 to 49. This panel recommended that women aged 40 to 49 should be counseled about potential benefits and harms before making decisions about mammography. In 2001, the CTFPHC concluded there was insufficient evidence to recommend for or against mammography in women aged 40 to 49. Aetna considers xeroradiography for breast imaging experimental and investigational because this method of radiography is obsolete. Aetna considers digital mammography a medically necessary acceptable alternative to film mammography. screening mammography in women aged 75 years or older,. Women who meet criteria for BRCA mutation testing in CPB 227 - BRCA Testing, Prophylactic Mastectomy, and Prophylactic Oophorectomy; or. The U.S. Preventive Services Task Force (USPSTF) revised their recommendations for mammography screening in 2009. Whereas they had formerly recommended routine screening every 1 to 2 years starting at age 40, they now recommend against routine screening for women aged 40 to 49 and biennial rather than annual screening for women aged 50 to 74. In their 2009 recommendations, the USPSTF recommend that women aged 40 to 49 consider their personal risk for developing breast cancer before deciding to participate in regular, biennial screening. The USPSTF concluded that the current evidence is insufficient to assess the additional benefits and harms of. With full field digital mammography (FFDM), two-dimensional (2D) X-ray images are recorded onto a computer, rather than directly onto film. The technique is the same as in screen-film mammography. Adjustments can be made during the procedure, thus reducing the need to repeat mammograms and reducing the exposure to radiation. Images of the entire breast can be captured regardless of tissue density. Screening mammography aims to reduce morbidity and mortality from breast cancer by early detection and treatment of occult malignancies. There is extensive evidence from a variety of well-conducted, randomized controlled studies that annual or biennial mammography is effective in reducing breast cancer mortality by 30 % in women aged 50 to 69 years. Data on women under age 50 are less clear. Results from the Canadian National Breast Screening Study (CNBSS) suggest that the contribution of mammography over good physical examinations to breast cancer mortality reduction may be less than has been assumed. This observation re-emphasizes a truism of screening -- that it is not necessary to detect cancers as early as possible to obtain a benefit -- it is only necessary to detect them early enough. What is early enough in any individual case is uncertain because there are insufficient outcomes data. This has made it difficult for professional societies to develop specific mammography screening recommendations for high-risk women. Currently, there are no guideline recommendations from leading medical professional organizations to screen men at risk for hereditary breast cancer with mammography. Robson (2002) explained "There are no established guidelines for screening of men at risk for hereditary breast cancer. It is reasonable to suggest periodic self-examination and evaluation by a provider experienced in clinical breast examination. The utility of screening mammography in men is unknown, although it is technically possible in at least some individuals." However, diagnostic mammography may be indicated in men with a breast mass on clinical examination (American Cancer Society, 2003). On behalf of the USPSTF, Siu (2016) updated the 2009 USPSTF recommendation on screening for breast cancer. The USPSTF reviewed the evidence on the following:
effectiveness of breast cancer screening in reducing breast cancer-specific and all-cause mortality, as well as the incidence of advanced breast cancer and treatment-related morbidity; harms of breast cancer screening; test performance characteristics of digital breast tomosynthesis as a primary screening strategy; and adjunctive screening in women with increased breast density. In addition, the USPSTF reviewed comparative decision models on optimal starting and stopping ages and intervals for screening mammography; how breast density, breast cancer risk, and comorbidity level affect the balance of benefit and harms of screening mammography; and the number of radiationinduced breast cancer cases and deaths associated with different screening mammography strategies over the course of a woman's lifetime. This recommendation applies to asymptomatic women aged 40 years or older who do not have pre-existing breast cancer or a previously diagnosed high-risk breast lesion and who are not at high risk for breast cancer because of a known underlying genetic mutation (such as a BRCA1 or BRCA2 gene mutation or other familial breast cancer syndrome) or a history of chest radiation at a young age. clinical breast examination (CBE) beyond screening mammography in women aged 40 years or older, and. In addition, the USPSTF recommended against clinicians teaching women how to perform breast self-examination. The American Medical Association (AMA), the Society of Breast Imaging (SBI), the American College of Radiology (ACR), and the American Cancer Society (ACS), all support screening with mammography and CBE beginning at age 40. Recent recommendations from the SBI and the ACR (2010) released after the 2009 USPSTF recommendations, which recommended that average-risk women wait until age 50 to undergo screening mammography, continue to support yearly screening mammography beginning at age 40 for women at average-risk for breast cancer. The American College of Obstetricians and Gynecologists (ACOG, 2000) supports screening with mammography beginning at age 40 and CBE beginning at age 19. The Canadian Task Force on Preventive Health Care (CTFPHC), the American Academy of Family Physicians (AAFP), and the American College of Preventive Medicine (ACPM) recommend beginning mammography for average-risk women at age 50. The AAFP and ACPM recommend that mammography in high-risk women begin at age 40, and AAFP recommends that all women aged 40 to 49 be counseled about the risks and benefits of mammography before making decisions about screening. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening mammography in women aged 75 years or older (I statement). Aetna considers annual mammography screening a medically necessary preventive service for women aged 40 and older. Annual mammography is also considered medically necessary for younger women who are judged to be at high-risk including: With screen-film mammography, 2D X-ray images of the breasts are recorded onto photographic film. Each breast is positioned and compressed between two clear plates, which are attached to a specialized camera, and pictures are taken from two directions. Berg et al (2008) compared the diagnostic yield, defined as the proportion of women with positive screen test results and positive reference standard, and performance of screening with ultrasound plus mammography versus mammography alone in women at elevated risk of breast cancer. A total of 2,809 women, with at least heterogeneously dense breast tissue in at least 1 quadrant, were recruited from 21 sites to undergo mammographic and physician-performed ultrasonographic examinations in randomized order by a radiologist masked to the other examination results. Reference standard was defined as a combination of pathology and 12-month follow-up and was available for 2,637 (96.8 %) of the 2,725 eligible participants.
Main outcome measures included diagnostic yield, sensitivity, specificity, and diagnostic accuracy (assessed by the area under the receiver operating characteristic curve) of combined mammography plus ultrasound versus mammography alone and the positive predictive value of biopsy recommendations for mammography plus ultrasound versus mammography alone. A total of 40 participants (41 breasts) were diagnosed with cancer: 8 suspicious on both ultrasound and mammography, 12 on ultrasound alone, 12 on mammography alone, and 8 participants (9 breasts) on neither. The diagnostic yield for mammography was 7.6 per 1,000 women screened (20 of 2,637) and increased to 11.8 per 1,000 (31 of 2,637) for combined mammography plus ultrasound; the supplemental yield was 4.2 per 1,000 women screened (95 % confidence interval [CI]: 1.1 to 7.2 per 1,000; p = 0.003 that supplemental yield is 0). The diagnostic accuracy for mammography was 0.78 (95 % CI: 0.67 to 0.87) and increased to 0.91 (95 % CI: 0.84 to 0.96) for mammography plus ultrasound (p = 0.003 that difference is 0). Of 12 supplemental cancers detected by ultrasound alone, 11 (92 %) were invasive with a median size of 10 mm (range of 5 to 40 mm; mean [SE], 12.6 [3.0] mm) and 8 of the 9 lesions (89 %) reported had negative nodes. The positive predictive value of biops. Screening mammography for other women is considered experimental and investigational because its benefits in these other women are unproven.