What is the CPT code for Oncotype DX?
81519
To bill an Oncotype Breast service, please provide the following claim information: CPT code 81519 – Oncology (breast)
What is procedure code 81519?
CPT® 81519, Under Multianalyte Assays with Algorithmic Analyses. The Current Procedural Terminology (CPT®) code 81519 as maintained by American Medical Association, is a medical procedural code under the range – Multianalyte Assays with Algorithmic Analyses.
Is Oncotype DX test covered by insurance?
All major insurance carriers cover the Oncotype DX test for eligible patients with early-stage invasive breast cancer. Medicare has established coverage for the Oncotype DX test for patients with DCIS (non-invasive) breast cancer, although coverage outside of Medicare will vary by insurance plan.
Is Oncotype DX covered by Medicare?
Medicare and most private insurance carriers cover the Oncotype DX Breast Recurrence Score test for eligible patients with early-stage invasive breast cancer.
What is the CPT code for diagnostic mammogram?
What are insurance billing codes for additional breast screening tests?
| Test | CPT Code |
|---|---|
| 2D Mammogram (screening) | 77067 (both breasts, 2-views of each) |
| 2D Mammogram (diagnostic) | 77065 (one breast) 77066 (both breasts) |
| 3D Mammogram /tomosynthesis (screening) | 77067 (2D both breasts) + 77063 (3D both breasts ) |
How much does an Oncotype test cost?
The Oncotype DX test costs about $4,000. For insurance- and payment-related questions, call 1-866-ONCOTYPE (1-866-662-6897) or email [email protected].
Who is eligible for Oncotype DX?
NOTE: If your patient has been diagnosed with non-invasive breast cancer, ductal carcinoma in situ (DCIS) she may be eligible for the Oncotype DX Breast DCIS Score test. The Breast Recurrence Score test can provide insight into specific diagnoses, treatment options, or risks factors, such as: Node-negative cancer
What is the difference between CPT code 77063 and 77067?
A patient with commercial insurance undergoes a screening mammogram. This payer follows CPT guidelines. Report 77067. If screening tomosynthesis is ordered and performed, also report 77063.
What is the CPT code 77067?
CPT® 77067, Under Breast, Mammography The Current Procedural Terminology (CPT®) code 77067 as maintained by American Medical Association, is a medical procedural code under the range – Breast, Mammography.
What is Oncotype DX testing?
The Oncotype DX is a test that may predict how likely it is that your breast cancer will return. It also predicts whether you will benefit from having chemotherapy in addition to hormone therapy. The test results can help you and your doctors make a treatment plan that’s right for you.
Is Oncotype DX FDA approved?
Although not formally approved by the US Food and Drug Administration (FDA), Oncotype DX is currently the only genomic assay recommended in treatment guidelines published by the American Society of Clinical Oncology (ASCO) and the National Comprehensive Cancer Center Network (NCCN) and is also recommended by both the …