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Reimbursement
Cytyc has provided the following coding, billing and reimbursement information for billing professionals at medical facilities. Providers are responsible for determining insurance coverage as well as determining the appropriate billing and coding submissions.
| FirstCyte® Breast Test
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| CPT Code |
Text Description |
| 0046T |
Catheter lavage of a mammary duct(s) for
collection of cytology specimen(s), in high risk
individuals (Gail Risk Model scoring or prior personal
history or breast cancer), each breast; single duct |
| 0047T |
Each additional duct |
| For 2004, the FirstCyte Breast Test has not received
a category I CPT code and thus has not received relative value
units (RVU's). Despite this, more than 30 health plans have
developed medical policy providing
coverage for ductal lavage for women considered to be at high
risk of developing breast cancer. Providers should confirm
coverage with the insurance company
in question. |
FirstCyte Reimbursement Helpline
You can call the toll-free Reimbursement Helpline at 1-888-563-7246 Monday-Friday
from 8:30 AM - 5:30 PM EST. Each provider's office is assigned a Reimbursement
Specialist who can provide a wide range of reimbursement assistance, which
includes:
- Answering questions about reimbursement for the FirstCyte Breast Test
- Helping with prior authorization
- Providing helpful sample documents
- Sharing information on prior authorization experience with the FirstCyte Breast Test
- Helping with the appeals process if a prior authorization or claim is denied
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