Procedure Codes and Descriptors


Medicare providers must use the following Healthcare Common Procedure Coding System/Current Procedural Terminology (HCPCS/CPT) codes listed below.


77051
Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; diagnostic mammography (List separately in addition to code for primary procedure) (Use 77051 in conjunction with 77055, 77056)


77052
Computer-aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation, with or without digitization of film radiographic images; screening mammography (List separately in addition to code for primary procedure) (Use 77052 in conjunction with 77057)


77055 Mammography; unilateral
(Use 77055 in conjunction with 77051 for computer-aided detection applied to a diagnostic mammogram)


77056 Mammogram; bilateral
(Use 77056 in conjunction with 77051 for computer-aided detection applied to a diagnostic mammogram)


77057 Screening mammography, bilateral (2-view film study of each breast)
(Use 77057 in conjunction with 77052 for computer-aided detection applied to a screening mammogram)
(For electrical impedance breast scan, use 76499)


G0202  Screening mammography, producing direct digital image, bilateral, all views



G0204 Diagnostic mammography, producing direct digital image, bilateral, all views



G0206

Diagnostic mammography, producing direct digital image, unilateral, all views





Coverage Indications, Limitations, and/or Medical Necessity


    Screening Mammogram


    A screening mammography is a radiologic procedure furnished to a woman without signs or symptoms of breast disease, for the purpose of early detection breast cancer,and includes a physician’s interpretation of the results of the procedure. A screening mammogram does not require a physician’s referral, however, detection of a radiographic abnormality, may prompt the interpreting radiologist to order additional views on the same day. When this is the case, the mammography is no longer considered to be a screening exam and should be reported as a diagnostic mammogram. Radiologists who order additional tests must refer back to the treating physician or qualified non-physician practitioner for his/her UPIN and report back to the treating physician the condition of the patient. No separate reimbursement will be made for additional views. The cost for additional views is included in the cost of the diagnostic mammography service. Screening mammogram(s) (digital and non-digital) for the following indications are allowed:




        Asymptomatic women ages 40 and older are eligible for a screening mammography (digital and non-digital) performed after at least 11 months have passed following the month in which the last screening mammography was performed.
        Women between the ages of 35 and 39 are eligible to receive one baseline screening mammogram.
        Women with breast implants are eligible for screening mammography when the screening mammogram is performed within the aforementioned age and frequency limitations.
        Services will only be allowed if supplied by certified suppliers or FDA-certified mammography centers.




    Limitations




        The screening mammogram must be, at a minimum a two-view exposure (cranio-caudal and a medial lateral oblique view) of each breast.
        Payment may not be made for a screening mammography performed on a woman under age 35.


        Payment may be made for only one screening mammography performed on a woman over age 34, but under age 40.
        Screening mammograms performed prior to 11 months lapsing following the month in which the last screening mammography service was rendered is noncovered.


        Facilities that perform screening mammography services may not release screening mammography x-rays for interpretation to physicians who are not approved under the facility’s certification number unless the patient has requested a transfer of the films from one facility to another for a second opinion or the patient has moved to another part of the country where the next screening mammography will be performed.




    Diagnostic Mammography


    A diagnostic mammography is a radiologic procedure furnished to a man or woman with signs and symptoms of breast disease, or a personal history of breast cancer, or a personal history of biopsy-proven benign breast disease, and includes a physician’s interpretation of the results of the procedure.


    Diagnostic mammogram(s) are allowed for the following indications:


    -the patient is under the care of the referring/ordering physician or qualified non-physician practitioner;
    -there are signs and/or symptoms suggestive of malignancy (mass, some types of spontaneous nipple discharge or skin changes);
    -there are possible radiographic abnormalities detected on screening mammography;
    -there is short interval follow-up (less than one year) necessary for unresolved clinical/radiographic concerns; or
    -follow-up of established history of a malignancy is necessary


    Diagnostic breast evaluation may be indicated in cases of a personal history of malignancy and in cases of benign biopsy-proven breast disease. These diagnoses should not, however, routinely warrant a diagnostic mammography.


    A breast implant does not necessarily imply that a mammogram is diagnostic in nature. Although additional views may be needed, these additional views do not necessarily constitute a diagnostic mammogram, unless there are specific findings that require investigation.


    Medicare Part B covers diagnostic mammography services if they are furnished by a facility that meets the certification requirements of section 354 of the Public Health Service Act (PHS Act), as implemented by 21 CFR part 900, subpart B. As of October 1, 1994, the Mammography Quality Standards Act requires that all mammography centers that bill Medicare be certified by the Food and Drug Administration (FDA). Only FDA-certified mammography centers will be reimbursed.


    A physician (or qualified non-physician practitioner) referral is required for diagnostic mammography. The patient must be under the care of the physician (or qualified non-physician practitioner) who orders the procedure. The order should specify the diagnosis prompting the referral for a diagnostic mammogram.


    Diagnostic mammography should be performed under the direct, on-site supervision of an interpreting physician qualified in mammography. Diagnostic mammography may require that the performing radiologist review the history with the patient, review the prior mammograms, and perform an examination as part of the mammography. Also, the findings of the examination are typically discussed with the patient at the completion of the mammogram. Therefore, if telemammography is being used with digital diagnostic mammography, the radiologist need not be present for the mammography; however, he/she must be available to discuss the history with the patient, examine the patient, and discuss results of the findings of the examination with the patient within an acceptable period of time.


    Limitations


    This policy does not outline complete indications and limitations of breast ultrasound but addresses the limitations of screening mammography with breast ultrasound. (There is no Medicare benefit.)


    Breast ultrasound is not a Medicare preventive services benefit. Therefore, routine breast cancer screening with ultrasound (including patients with dense breast tissue) is not a Medicare covered service. Clinical evidence has not yet demonstrated that routine use of ultrasonography as an adjunct to screening mammography reduces the mortality rate from breast cancer.


    Breast ultrasonography may be reasonable and necessary in addition to a diagnostic mammography for the evaluation of some ambiguous mammographic or palpable masses, focal asymmetry, or dense breast tissue that may represent or mask a mass. Breast ultrasonography may also be performed for non-palpable masses, detected by mammography, to differentiate cysts from solid lesions.


    Breast ultrasound is medically reasonable and necessary as an aid for radiologists to localize breast lesions and in guiding placement of instruments for cyst aspiration and percutaneous breast biopsies. (This is not an all-inclusive list.) If breast ultrasound is medically reasonable and necessary and done on the same day as a screening mammography, the screening mammography becomes diagnostic.


    The request (order) for the ultrasound examination must be originated by a treating physician/NPP. This requirement is not applicable to hospital based radiologists for inpatient or outpatient breast ultrasound.


    A radiologist performing a therapeutic interventional procedure is considered a treating physician. A radiologist performing a diagnostic interventional or diagnostic procedure is not considered a treating physician.


    If the testing facility has no order for breast ultrasound and cannot reach the treating physician/practitioner to obtain a new order for the addition of breast ultrasound when needed and documents this in the medical record, then the testing facility may furnish the additional diagnostic test if all of the following criteria apply:




        The testing center performs the mammography ordered by the treating physician/practitioner;


        The interpreting physician at the testing facility determines and documents that, because of the abnormal result of the diagnostic test performed, an additional diagnostic test is medically necessary;


        Delaying the performance of the additional diagnostic test would have an adverse effect on the care of the beneficiary;


        The result of the test is communicated to and is used by the treating physician/practitioner in the treatment of the beneficiary; and


        The interpreting physician at the testing facility documents in his/her report why additional testing was done.




    Breast sonography should be performed under the general supervision of a physician qualified in breast ultrasonography.



    The ultrasound study must have a permanent written record along with the accompanying set of images in retrievable image storage format. The images and report should become a part of the patient’s permanent medical record.


A diagnostic mammogram is an x-ray of the breast that is used to check for breast cancer after a lump or other sign or symptom of breast cancer has been found. Signs of breast cancer may include pain, skin thickening, nipple discharge, or a change in breast size or shape. A diagnostic mammogram may also be used to evaluate changes found during a screening mammogram, or to view breast tissue when it is difficult to obtain a screening mammogram because of special circumstances, such as the presence of breast implants.




1. A diagnostic mammogram is a diagnostic test covered by Medicare under the following conditions:

2. An individual has distinct signs and symptoms for which a mammogram is indicated;

3. An individual has a history of breast cancer; or

4. An individual is asymptomatic, but based on the individual’s history and other factors the physician considers significant, the physician’s judgment is that a mammogram is appropriate.




Coverage Information

Medicare provides coverage of a breast cancer screening mammogram annually (i.e., at least 11 full months have passed following the month in which the last Medicare screening mammogram was covered) for all female beneficiaries age 40 or older. Medicare also provides coverage of one baseline mammogram for female beneficiaries between the ages of 35 and 39.


* Under age 35: No payment allowed

* Age 35 – 39: Baseline (only one screening allowed for women in this age group)

* Over age 39: Annual (11 full months have elapsed following the month of last screening)






Diagnosis Requirements


V76.11
Special screening for malignant neoplasm, screening mammogram for high-risk patient

V76.12
Special screening for malignant neoplasm, other screening mammography


General information

Mammography services may be billed by the following three categories:

* Technical Component (TC) – services rendered outside the scope of the physician’s interpretation of the results of an examination.


* Professional Component (PC) – physician’s interpretation of the results of an examination.


* Global Component – encompasses both the technical and professional components.


Global billing is not permitted for services furnished in an outpatient facility. Critical Access Hospitals (CAHs) may not use global HCPCS codes as the TC and PC components are paid under different methodologies.




Reasons for Claim Denial

The following are examples of situations when Medicare may deny coverage of mammography screening tests:


* The beneficiary is not at least age 35.


* The beneficiary has received a covered screening mammogram during the past year.


* The beneficiary received a screening mammogram from a non-FDA or a non-State/MQSA-certified mammography provider.




Billing and Coding Tips

Effective for claims with dates of service January 1, 2007 and later, providers report new CPT  codes 77051, 77052, 77055, 77056, and 77057 in place of current CPT codes 76082, 76083, 76090, 76091, and 76092 respectively


Contractors shall advise providers to report new  codes for mammography claims effective  January 1, 2007 as follows:


• report code 77051 in place of code 76082;


•report code 77052 in place of code 76083;


• report code 77055 in place of code 76090;


• report code 77056 in place of code 76091;


• report code 77057 in place of code 76092;




Contractors shall use the following type of service (TOS) for the new codes:


77051—TOS 4
77052—TOS 1
77055—TOS 4
77056—TOS 4
77057—TOS 1 


Billing Requirements.–Only one screening mammogram, either 76092 or G0202 may be billed in a calendar year. Therefore, advise your providers not to submit claims reflecting both a film screening mammography (76092) and a digital screening mammography G0202. Also advise your providers not to submit claims reflecting HCPCS codes 76090 or 76091 (diagnostic
mammography-film) and G0204 or G0206 (diagnostic mammography-digital). Deny the claim when both a film and digital screening or diagnostic mammography are reported. However, a screening and diagnostic mammography can be billed together.


C. Billing and Payment of Computer Aided Detection (CAD) Services.–Code 76085, “Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, screening mammography”, for CAD has been established as an add on code that can be billed in conjunction with primary service code G0202 as well as 76092.


There is no Part B deductible. However, coinsurance is applicable. The add-on code cannot be billed alone. Deny the claim if only the add-on code is billed.


Code G0236, “Digitization of film radiographic images with computer analysis for lesion detection and further physician review for interpretation, diagnostic mammography”, for CAD has been established as an add on code that can be billed in conjunction with primary service code G0204 or G0206 as well as existing codes 76090 or 76091. The Part B deductible and co-insurance apply.


The add-on code cannot be billed alone. Deny the claim if only the add-on code is billed. 


New Modifier  “-GG”: Performance and payment of a screening mammography and  diagnostic mammography on same patient same day – This is billed with the Diagnostic Mammography code to show the test changed from a screening test to a diagnostic test. Contractors will pay both the screening and diagnostic mammography tests. This modifier is for tracking purposes only. This applies to claims with dates of service on or after January 1, 2002. 


• Mammogram/1 procedure per calendar year


• 77051, 77052, 77055, 77056, 77057, G0202, G0204, G0206: Mammography All mammography codes can be filed with modifier 26 for the interpretation of the mammogram. 

G0202  Screening mammography, producing direct digital image, bilateral, all views. Code Effective April 1, 2001.


NOTE: For claims with dates of service April 1, 2003 – December 31, 2003, code G0202 may be billed in conjunction with 76085.


Carriers and FIs make payment under the Medicare physician fee schedule. There is no Part B deductible. However, coinsurance is applicable. 





Contractors must assure that claims containing code 76085 also contain HCPCS code 76092 or G0202. If not, FIs return claims to the provider with an explanation that payment for code 76085 cannot be made when billed alone. Carriers deny payment for 76085 when billed without 76092 or G0202.


Effective with claims with dates of service January 1, 2004 thru December 31, 2006, HCPCS code 76083, “Computer aided detection (computer algorithm analysis of digital image data for lesion detection) with further physician review for interpretation with or without digitization of film radiographic images; screening  mammography (list separately in addition to code for primary procedure),” can be billed in conjunction with the primary service mammography code 76092 or G0202. 


Contractors must assure that claims containing code 77052* (76083*) also contain HCPCS code 77057* (76092*) or G0202. FIs return claims containing code 77052* (76083*) that do not also contain HCPCS code 77057* (76092*) or G0202 with an explanation that payment for code 77052* (76083*) cannot be made when billed alone. Carriers deny payment for 77052* (76083*) when billed without 77057* (76092*) or G0202.




Code 76085, “Digitization of film radiographic images with computer analysis for lesion detection and further physician review for  interpretation, screening mammography,” for CAD has been established as an add on code that can be billed in conjunction with primary  service code G0202 as well as 76092. HCPCS code 76085 is deleted as of December 31, 2003. The Part B Deductible does not apply. However, coinsurance is applicable. FIs use the benefit pricing file provided by CMS to pay the above codes where payment is based on   the technical component of the Medicare physician fee schedule.  




ICD 10 Code


• Z12.31 Encounter for screening mammogram for malignant neoplasm of breast


• Z12.39 Encounter for other screening for malignant neoplasm of breast



A diagnostic mammogram (when the patient has an illness, disease or symptoms indicating the need for a mammogram) is covered whenever it is medically necessary. 




77057, +77052, G0202 Aged 35-39: one baseline  40: Annually >35 No Co-pay No Part B deductible None stated Z12.31 .


$7.75 01-Jan-16 77052-26 Professional Component $2.81 01-Jan-16 77052-TC Technical Component $4.94 01-Jan-16




ICD-10 Codes that Support Medical Necessity



    For screening mammography (77057, 77063 or G0202):


    For claims with dates of service on or after January 1, 2002, when a screening mammography and a diagnostic mammography are performed on the same date of service, for the same patient, append modifier -GG to the diagnostic mammography procedure code. Both the screening mammography and the diagnostic mammography procedure codes should be reported on the same claim:


    Group 1 Codes
    Z12.31* Encounter for screening mammogram for malignant neoplasm of breast
    Group 2 Paragraph
    For diagnostic mammography (77055, 77056, G0204, G0206 or G0279) billed with or without Modifier GG:
    Group 2 Codes
    C43.52 Malignant melanoma of skin of breast
    C43.59 Malignant melanoma of other part of trunk
    C44.501 Unspecified malignant neoplasm of skin of breast
    C44.509 Unspecified malignant neoplasm of skin of other part of trunk
    C44.511 Basal cell carcinoma of skin of breast
    C44.519 Basal cell carcinoma of skin of other part of trunk
    C44.521 Squamous cell carcinoma of skin of breast
    C44.529 Squamous cell carcinoma of skin of other part of trunk
    C44.591 Other specified malignant neoplasm of skin of breast
    C44.599 Other specified malignant neoplasm of skin of other part of trunk
    C45.9 Mesothelioma, unspecified
    C50.011 Malignant neoplasm of nipple and areola, right female breast
    C50.012 Malignant neoplasm of nipple and areola, left female breast
    C50.019 Malignant neoplasm of nipple and areola, unspecified female breast
    C50.021 Malignant neoplasm of nipple and areola, right male breast
    C50.022 Malignant neoplasm of nipple and areola, left male breast
    C50.029 Malignant neoplasm of nipple and areola, unspecified male breast
    C50.111 Malignant neoplasm of central portion of right female breast
    C50.112 Malignant neoplasm of central portion of left female breast
    C50.119 Malignant neoplasm of central portion of unspecified female breast
    C50.121 Malignant neoplasm of central portion of right male breast
    C50.122 Malignant neoplasm of central portion of left male breast
    C50.129 Malignant neoplasm of central portion of unspecified male breast
    C50.211 Malignant neoplasm of upper-inner quadrant of right female breast
    C50.212 Malignant neoplasm of upper-inner quadrant of left female breast
    C50.219 Malignant neoplasm of upper-inner quadrant of unspecified female breast
    C50.221 Malignant neoplasm of upper-inner quadrant of right male breast
    C50.222 Malignant neoplasm of upper-inner quadrant of left male breast
    C50.229 Malignant neoplasm of upper-inner quadrant of unspecified male breast
    C50.311 Malignant neoplasm of lower-inner quadrant of right female breast
    C50.312 Malignant neoplasm of lower-inner quadrant of left female breast
    C50.319 Malignant neoplasm of lower-inner quadrant of unspecified female breast
    C50.321 Malignant neoplasm of lower-inner quadrant of right male breast
    C50.322 Malignant neoplasm of lower-inner quadrant of left male breast
    C50.329 Malignant neoplasm of lower-inner quadrant of unspecified male breast
    C50.411 Malignant neoplasm of upper-outer quadrant of right female breast
    C50.412 Malignant neoplasm of upper-outer quadrant of left female breast
    C50.419 Malignant neoplasm of upper-outer quadrant of unspecified female breast
    C50.421 Malignant neoplasm of upper-outer quadrant of right male breast
    C50.422 Malignant neoplasm of upper-outer quadrant of left male breast
    C50.429 Malignant neoplasm of upper-outer quadrant of unspecified male breast
    C50.511 Malignant neoplasm of lower-outer quadrant of right female breast
    C50.512 Malignant neoplasm of lower-outer quadrant of left female breast
    C50.519 Malignant neoplasm of lower-outer quadrant of unspecified female breast
    C50.521 Malignant neoplasm of lower-outer quadrant of right male breast
    C50.522 Malignant neoplasm of lower-outer quadrant of left male breast
    C50.529 Malignant neoplasm of lower-outer quadrant of unspecified male breast
    C50.611 Malignant neoplasm of axillary tail of right female breast
    C50.612 Malignant neoplasm of axillary tail of left female breast
    C50.619 Malignant neoplasm of axillary tail of unspecified female breast
    C50.621 Malignant neoplasm of axillary tail of right male breast
    C50.622 Malignant neoplasm of axillary tail of left male breast
    C50.629 Malignant neoplasm of axillary tail of unspecified male breast
    C50.811 Malignant neoplasm of overlapping sites of right female breast
    C50.812 Malignant neoplasm of overlapping sites of left female breast
    C50.819 Malignant neoplasm of overlapping sites of unspecified female breast
    C50.821 Malignant neoplasm of overlapping sites of right male breast
    C50.822 Malignant neoplasm of overlapping sites of left male breast
    C50.829 Malignant neoplasm of overlapping sites of unspecified male breast
    C50.911 Malignant neoplasm of unspecified site of right female breast
    C50.912 Malignant neoplasm of unspecified site of left female breast
    C50.919 Malignant neoplasm of unspecified site of unspecified female breast
    C50.921 Malignant neoplasm of unspecified site of right male breast
    C50.922 Malignant neoplasm of unspecified site of left male breast
    C50.929 Malignant neoplasm of unspecified site of unspecified male breast
    C56.1 Malignant neoplasm of right ovary
    C56.2 Malignant neoplasm of left ovary
    C56.9 Malignant neoplasm of unspecified ovary
    C77.3 Secondary and unspecified malignant neoplasm of axilla and upper limb lymph nodes
    C78.00 Secondary malignant neoplasm of unspecified lung
    C78.01 Secondary malignant neoplasm of right lung
    C78.02 Secondary malignant neoplasm of left lung
    C78.1 Secondary malignant neoplasm of mediastinum
    C78.2 Secondary malignant neoplasm of pleura
    C78.7 Secondary malignant neoplasm of liver and intrahepatic bile duct
    C79.2 Secondary malignant neoplasm of skin
    C79.31 Secondary malignant neoplasm of brain
    C79.32 Secondary malignant neoplasm of cerebral meninges
    C79.40 Secondary malignant neoplasm of unspecified part of nervous system
    C79.49 Secondary malignant neoplasm of other parts of nervous system
    C79.51 Secondary malignant neoplasm of bone
    C79.52 Secondary malignant neoplasm of bone marrow
    C79.60 Secondary malignant neoplasm of unspecified ovary
    C79.61 Secondary malignant neoplasm of right ovary
    C79.62 Secondary malignant neoplasm of left ovary
    C79.81 Secondary malignant neoplasm of breast
    C80.0 Disseminated malignant neoplasm, unspecified
    C80.1 Malignant (primary) neoplasm, unspecified
    D03.52 Melanoma in situ of breast (skin) (soft tissue)
    D03.59 Melanoma in situ of other part of trunk
    D04.5 Carcinoma in situ of skin of trunk
    D05.00 Lobular carcinoma in situ of unspecified breast
    D05.01 Lobular carcinoma in situ of right breast
    D05.02 Lobular carcinoma in situ of left breast
    D05.10 Intraductal carcinoma in situ of unspecified breast
    D05.11 Intraductal carcinoma in situ of right breast
    D05.12 Intraductal carcinoma in situ of left breast
    D05.80 Other specified type of carcinoma in situ of unspecified breast
    D05.81 Other specified type of carcinoma in situ of right breast
    D05.82 Other specified type of carcinoma in situ of left breast
    D05.90 Unspecified type of carcinoma in situ of unspecified breast
    D05.91 Unspecified type of carcinoma in situ of right breast
    D05.92 Unspecified type of carcinoma in situ of left breast
    D22.5 Melanocytic nevi of trunk
    D23.5 Other benign neoplasm of skin of trunk
    D24.1 Benign neoplasm of right breast
    D24.2 Benign neoplasm of left breast
    D24.9 Benign neoplasm of unspecified breast
    D48.5 Neoplasm of uncertain behavior of skin
    D48.60 Neoplasm of uncertain behavior of unspecified breast
    D48.61 Neoplasm of uncertain behavior of right breast
    D48.62 Neoplasm of uncertain behavior of left breast
    D49.1 Neoplasm of unspecified behavior of respiratory system
    D49.2 Neoplasm of unspecified behavior of bone, soft tissue, and skin
    D49.3 Neoplasm of unspecified behavior of breast
    D49.6 Neoplasm of unspecified behavior of brain
    D49.7 Neoplasm of unspecified behavior of endocrine glands and other parts of nervous system
    I80.8 Phlebitis and thrombophlebitis of other sites
    M70.80 Other soft tissue disorders related to use, overuse and pressure of unspecified site
    M70.88 Other soft tissue disorders related to use, overuse and pressure other site
    M70.89 Other soft tissue disorders related to use, overuse and pressure multiple sites
    M70.90 Unspecified soft tissue disorder related to use, overuse and pressure of unspecified site
    M70.98 Unspecified soft tissue disorder related to use, overuse and pressure other
    M70.99 Unspecified soft tissue disorder related to use, overuse and pressure multiple sites
    M79.5 Residual foreign body in soft tissue
    M79.81 Nontraumatic hematoma of soft tissue
    M79.89 Other specified soft tissue disorders
    M79.9 Soft tissue disorder, unspecified
    N60.01 Solitary cyst of right breast
    N60.02 Solitary cyst of left breast
    N60.09 Solitary cyst of unspecified breast
    N60.11 Diffuse cystic mastopathy of right breast
    N60.12 Diffuse cystic mastopathy of left breast
    N60.19 Diffuse cystic mastopathy of unspecified breast
    N60.21 Fibroadenosis of right breast
    N60.22 Fibroadenosis of left breast
    N60.29 Fibroadenosis of unspecified breast
    N60.31 Fibrosclerosis of right breast
    N60.32 Fibrosclerosis of left breast
    N60.39 Fibrosclerosis of unspecified breast
    N60.41 Mammary duct ectasia of right breast
    N60.42 Mammary duct ectasia of left breast
    N60.49 Mammary duct ectasia of unspecified breast
    N60.81 Other benign mammary dysplasias of right breast
    N60.82 Other benign mammary dysplasias of left breast
    N60.89 Other benign mammary dysplasias of unspecified breast
    N60.91 Unspecified benign mammary dysplasia of right breast
    N60.92 Unspecified benign mammary dysplasia of left breast
    N60.99 Unspecified benign mammary dysplasia of unspecified breast
    N61.0 Mastitis without abscess
    N61.1 Abscess of the breast and nipple
    N62 Hypertrophy of breast
    N63 Unspecified lump in breast
    N64.0 Fissure and fistula of nipple
    N64.1 Fat necrosis of breast
    N64.2 Atrophy of breast
    N64.3 Galactorrhea not associated with childbirth
    N64.4 Mastodynia
    N64.51 Induration of breast
    N64.52 Nipple discharge
    N64.53 Retraction of nipple
    N64.59 Other signs and symptoms in breast
    N64.81 Ptosis of breast
    N64.82 Hypoplasia of breast
    N64.89 Other specified disorders of breast
    N64.9 Disorder of breast, unspecified
    N65.0 Deformity of reconstructed breast
    N65.1 Disproportion of reconstructed breast
    R59.0 Localized enlarged lymph nodes
    R59.1 Generalized enlarged lymph nodes
    R59.9 Enlarged lymph nodes, unspecified
    R92.0 Mammographic microcalcification found on diagnostic imaging of breast
    R92.1 Mammographic calcification found on diagnostic imaging of breast
    R92.2 Inconclusive mammogram
    R92.8 Other abnormal and inconclusive findings on diagnostic imaging of breast
    R93.9 Diagnostic imaging inconclusive due to excess body fat of patient
    S20.00XA Contusion of breast, unspecified breast, initial encounter
    S20.01XA Contusion of right breast, initial encounter
    S20.02XA Contusion of left breast, initial encounter
    S21.001A Unspecified open wound of right breast, initial encounter
    S21.002A Unspecified open wound of left breast, initial encounter
    S21.009A Unspecified open wound of unspecified breast, initial encounter
    S21.011A Laceration without foreign body of right breast, initial encounter
    S21.012A Laceration without foreign body of left breast, initial encounter
    S21.019A Laceration without foreign body of unspecified breast, initial encounter
    S21.021A Laceration with foreign body of right breast, initial encounter
    S21.022A Laceration with foreign body of left breast, initial encounter
    S21.029A Laceration with foreign body of unspecified breast, initial encounter
    S21.031A Puncture wound without foreign body of right breast, initial encounter
    S21.032A Puncture wound without foreign body of left breast, initial encounter
    S21.039A Puncture wound without foreign body of unspecified breast, initial encounter
    S21.041A Puncture wound with foreign body of right breast, initial encounter
    S21.042A Puncture wound with foreign body of left breast, initial encounter
    S21.049A Puncture wound with foreign body of unspecified breast, initial encounter
    S21.051A Open bite of right breast, initial encounter
    S21.052A Open bite of left breast, initial encounter
    S21.059A Open bite of unspecified breast, initial encounter
    S28.211A Complete traumatic amputation of right breast, initial encounter
    S28.212A Complete traumatic amputation of left breast, initial encounter
    S28.219A Complete traumatic amputation of unspecified breast, initial encounter
    S28.221A Partial traumatic amputation of right breast, initial encounter
    S28.222A Partial traumatic amputation of left breast, initial encounter
    S28.229A Partial traumatic amputation of unspecified breast, initial encounter
    S29.001A Unspecified injury of muscle and tendon of front wall of thorax, initial encounter
    S29.009A Unspecified injury of muscle and tendon of unspecified wall of thorax, initial encounter
    S29.091A Other injury of muscle and tendon of front wall of thorax, initial encounter
    S29.099A Other injury of muscle and tendon of unspecified wall of thorax, initial encounter
    S29.8XXA Other specified injuries of thorax, initial encounter
    S29.9XXA Unspecified injury of thorax, initial encounter
    S39.001A Unspecified injury of muscle, fascia and tendon of abdomen, initial encounter
    S39.091A Other injury of muscle, fascia and tendon of abdomen, initial encounter
    S39.81XA Other specified injuries of abdomen, initial encounter
    S39.91XA Unspecified injury of abdomen, initial encounter
    T85.41XA Breakdown (mechanical) of breast prosthesis and implant, initial encounter
    T85.42XA Displacement of breast prosthesis and implant, initial encounter
    T85.43XA Leakage of breast prosthesis and implant, initial encounter
    T85.44XA Capsular contracture of breast implant, initial encounter
    T85.49XA Other mechanical complication of breast prosthesis and implant, initial encounter
    T85.79XA Infection and inflammatory reaction due to other internal prosthetic devices, implants and grafts, initial encounter
    Z03.89 Encounter for observation for other suspected diseases and conditions ruled out
    Z08 Encounter for follow-up examination after completed treatment for malignant neoplasm
    Z77.123 Contact with and (suspected) exposure to radon and other naturally occuring radiation
    Z77.128 Contact with and (suspected) exposure to other hazards in the physical environment
    Z77.9 Other contact with and (suspected) exposures hazardous to health
    Z85.3 Personal history of malignant neoplasm of breast
    Z85.831 Personal history of malignant neoplasm of soft tissue
    Z85.89 Personal history of malignant neoplasm of other organs and systems
    Z91.89 Other specified personal risk factors, not elsewhere classified
    Z92.89 Personal history of other medical treatment
    Z98.82 Breast implant status

    Z98.86 Personal history of breast implant removal