2025 CPT code 76642

Limited ultrasound of one breast, real-time with image documentation, including axilla if performed.

Report only once per breast, per session.If a complete breast ultrasound is performed, code 76641 should be used instead.

Modifiers 26 (professional component), TC (technical component), and 50 (bilateral procedure) may be appended as appropriate.

Medical necessity for a limited breast ultrasound (76642) is established when the clinical indication justifies focusing on specific areas of the breast, such as a palpable mass, suspicious finding on mammography, or follow-up evaluation of a known lesion.

The radiologist or qualified sonographer performs the ultrasound examination. This includes positioning the patient, applying the transducer, acquiring and interpreting the images, and preparing the report.

IMPORTANT Use 76641 for a complete unilateral breast ultrasound.For axillary ultrasound only, use 76882.Do not report this code in the same session as 76641 for the same breast.

In simple words: This code covers a focused ultrasound scan of one breast. The doctor uses sound waves to create images of a specific part of the breast, possibly including the underarm area.Pictures are saved and a report is written to describe what was found.

This CPT code represents a focused, unilateral breast ultrasound examination.The examination is limited to one or more, but not all, of the following areas: four breast quadrants, retroareolar region, and axilla (if performed).Real-time imaging with image documentation is required.A comprehensive written report detailing the findings is mandatory.

Example 1: A patient presents with a palpable breast lump in the upper outer quadrant of the right breast. A focused ultrasound is performed (76642) to evaluate the mass and its characteristics., A patient undergoes a breast biopsy, and a limited ultrasound (76642) is performed to guide needle placement and verify the location of the lesion., A patient with a history of breast cancer has follow-up ultrasound (76642) to monitor for recurrence. The examination focuses on areas of previous surgical intervention or areas of concern.

* Detailed patient history and clinical indication for the ultrasound.* Images clearly showing the area(s) examined.* Measurements (if applicable)* Comprehensive written report with findings, including descriptions of the elements included in the exam, or explanation of why any elements were not visualized.

** This code should only be used when a limited examination is clinically appropriate.If a comprehensive examination of all breast quadrants and retroareolar region is necessary, code 76641 should be used.

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