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Official Description

Opto-acoustic imaging, breast (including axilla when performed), unilateral, with image documentation, analysis and report, obtained with ultrasound examination
Short Descr Uni breas optoacoustic imag
Coverage Special coverage instructions apply
Pricing Indicator(s) 53 – Statute
MPI A – Not applicable, as HCPCS priced under one methodology
Statute 1833(t)
Cross-Reference(s) 0857T
BETOS I4B – Imaging/procedure - other
TOS Code(s) 4 – Diagnostic radiology
Added Date 10/1/2023
Termination Date 12/31/2023
APC Status Indicator Procedure or Service, Not Discounted when Multiple
MUE Not applicable/unspecified.
MUE Not applicable/unspecified.
OTS Orthotic No
Date
Action
Notes
2023-12-31 Deleted Code deleted.
2023-10-01 Added Code added.
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