What this is, in plain language
A routine breast X-ray used to screen for breast cancer in people without symptoms, including computer-aided detection when used.
Why a clinician orders it
Breast cancer screening per USPSTF and ACR guidelines (USPSTF 2024 recommends biennial screening for women ages 40–74).
Medical necessity — what insurers usually look at
Covered as preventive care with no cost-share under most plans (ACA preventive services) and Medicare when done in-network. Diagnostic mammograms (77065/77066) for symptoms are billed differently and may apply to the deductible.
Documentation to ask about
- ✓Age and last screening date
- ✓In-network imaging facility
Questions for your provider
- ?Will this be billed as preventive or diagnostic?
- ?If additional images are needed today, will my cost change?
Why this code is in our seed set
One of the highest-volume preventive imaging codes; consistently in the CMS Top 200 Ranked by Services.
Validated against
- •USPSTF 2024 Final Recommendation, Breast Cancer Screening
- •ACR Appropriateness Criteria, Breast Cancer Screening
- •CMS Top 200 Level I CPT Codes Ranked by Services
Important: AuraCode is an educational tool. It does not provide medical, legal, or insurance advice, claims decisions, or approval guarantees. Final coverage depends on your specific plan, eligibility, diagnosis, submitted documentation, and your insurer's review.