CPT Code 77063: Screening Digital Breast Tomosynthesis, Add-on to Mammography

What is CPT Code 77063: Screening Digital Breast Tomosynthesis, Add-on to Mammography?

CPT code 77063 refers to screening digital breast tomosynthesis (DBT), bilateral, and is classified as an add-on procedure code to a standard screening mammogram (CPT Code 77067). This 3D mammography technique captures layered X-ray images of breast tissue from multiple angles, providing greater clarity compared to conventional mammography. The enhanced imaging allows physicians to detect breast abnormalities more accurately, improving early breast cancer detection and reducing false positives.

The 77063 CPT code is used only for screening purposes, not for diagnostic mammography, and must be billed in combination with the primary procedure CPT code 77067. It cannot be billed independently. When screening and diagnostic imaging are performed on the same day for the same patient, appropriate documentation and coding (e.g., Modifier GG) must support medical necessity.

Digital breast tomosynthesis is increasingly considered standard in screening mammography, particularly for patients with dense breasts. As the Centers for Medicare & Medicaid Services (CMS) expand coverage, accurate use of this procedure code is vital for appropriate reimbursement, improved patient outcomes, and compliance with Medicare Administrative Contractor (MAC) guidance.

CPT code 77063 documentation requirements

Accurate documentation must support the bilateral screening tomosynthesis's performance and medical necessity to meet billing and reimbursement standards for CPT code 77063. Providers must ensure their records meet payer expectations, especially those outlined by Medicare and Medicaid Services.

Documentation should include:

• A clear indication that the service was a screening mammography, not a diagnostic mammogram.
• Explicit reference to CPT code 77067 being the primary procedure performed in conjunction with CPT code 77063.
• A detailed description of how digital breast tomosynthesis was used to supplement the screening, enhancing standard 2D breast imaging.
• The date of service should reflect that both procedures occurred on the same day.
• A note describing that bilateral screening tomosynthesis was performed (unless reduced/unilateral, in which case Modifier 52 is applicable).
• Documentation of the technical component, professional component, or both, depending on whether the provider is billing for interpretation, equipment, or global service.
• When applicable, Modifier GG should be included if both screening and diagnostic mammography were done on the same patient.

This ensures that your claims align with CMS’s physician fee schedule and adhere to local coverage guidelines, reducing the risk of denials.

CPT code 77063 billing guidelines

Billing CPT code 77063 requires strict adherence to coding guidelines, as it is an add-on code that must always accompany a bilateral screening mammogram. Misuse or standalone reporting of this procedure code may result in denials or rejected claims.

Key billing points include:

• Always report 77063 in conjunction with code 77067 or HCPCS code G0202 (for Medicare).
• Do not bill CPT 77063 as a standalone service—it is intended to be listed separately in addition to the primary screening mammogram.
• Use Modifier 26 when billing for the professional component (e.g., radiologic interpretation).
• Use Modifier TC for the technical component (e.g., equipment usage, image acquisition).
• If unilateral DBT is performed, report with Modifier 52 to indicate reduced services.
• Do not report CPT 77063 with diagnostic codes 77065, 77066, or G0279; these are for diagnostic tomosynthesis services.
• Computer-aided detection (CAD) is included in this code and should not be separately billed.
• Refer to your payer contracts and the CMS physician fee schedule to confirm proper usage and reimbursement levels.
• Ensure claims reflect both the screening tomosynthesis and the conventional mammography component, performed on the same date.

Following these billing guidelines ensures that services are appropriately reimbursed, reduces audit risk, and supports payer compliance across both private insurance and Medicare/Medicaid.

Other related codes

The following codes are related to breast imaging procedures and are often used in conjunction with or instead of CPT code 77063, depending on clinical context. Understanding when to use each helps providers maintain billing compliance and accurate reporting.

• 77067 – Screening mammography, bilateral (2D); primary base code used with 77063.
• 77063 – Screening digital breast tomosynthesis, bilateral; add-on for 3D screening mammography.
• 77065 – Diagnostic mammography, unilateral; used when diagnostic evaluation is needed on one breast.
• 77066 – Diagnostic mammography, bilateral; for bilateral diagnostic mammograms.
• G0279 – Diagnostic digital breast tomosynthesis; used with 77065 or 77066 for Medicare patients.
• 77061 – Unilateral diagnostic digital breast tomosynthesis (non-Medicare).
• 77062 – Bilateral diagnostic digital breast tomosynthesis (non-Medicare).
• 76376/76377 – 3D rendering codes; not to be billed with 77063.

Proper understanding of this category of codes and their use ensures accurate submitting of claims, compliant billing, and optimized payment across all payers, including Centers for Medicare & Medicaid Services.