Reimbursement Information
Reimbursement information on coding, coverage and payment amounts for specific imaging service
Breast Imaging
Computed Tomography
Mammography
- Mammography, CAD and Digital Breast Tomosynthesis [PDF]
- Contrast Enhanced Spectral Mammography [PDF]
Ultrasound
- Automated Breast Ultrasound Screening [PDF]
- Ultrasound Point of Care [PDF]
- Ultrasound Primary Care [PDF]
- Vscan - Primary Care [PDF]
Contrast Media
- Omnipaque™ (iohexol) Injection [PDF]
- Visipaque™ (iodixanol) Injection [PDF]
- Omniscan™ (gadodiamide) Injection [PDF]
- Optison™ (Perflutren Protein-Type A Microspheres Injectable Suspension, USP) [PDF]
Radiopharmaceuticals
- Adreview™ (Iobenguane I 123 Injection) [PDF]
- Datscan™ CII (Ioflupane I 123 Injection) [PDF]
- Myoview™ (Kit for the Preparation of Technetium Tc99m Tetrofosmin for Injection) [PDF]
- Vizamyl™ (Flutametamol F18 Injection) [PDF]
X-Ray
- Digital X-Ray Tomosynthesis [PDF]
- Bone Density DXA [PDF]
Molecular Imaging
Diagnostic Elastography
For all other radiopharmaceuticals, please contact GE Healthcare Reimbursement Hotline @ 800 767 6664
Coverage Policies
Some representative private and public payer clinical policies that are transparent to the public are accessible via these web links. Remember to contact the payer since specific coverage decisions are based on a member benefit plan.
| Carrier Web Link Local Coverage Determinations |
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| Carrier Name | State | Web Link | Comment |
| Aetna | National | Medical - Physicians, hospitals, facilities and administrators | Click on Clinical Policy Bullentins (left side), accept terms, type in 77080 in search feature |
| BCBS | Alabama | Blue Cross and Blue Shield of Alabama : Providers : Use of "Physicians' Current Procedural Terminology," (CPT) | Accept terms, select "B", page down to Bone Mineral Density |
| BCBS - Premera | Alaska | Premera Blue Cross - Reference Info,Medical Policies | Accept terms, no written coverage policy - check under Bone Mass Measurement |
| BCBS | Arizona | AzBlue.com for Providers | Password Protected, may or may not have a written coverage policy |
| BCBS | Arkansas | Coverage Policy - Providers - Arkansas Blue Cross and Blue Shield | Accept terms, type in search feature 77080 |
| BC - Wellpoint (AKA Anthem) | California | BlueCross of California | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BS - CA | California | Guidelines & Resources - Provider Connection - Blue Shield of California | Password Protected, may or may not have a written coverage policy |
| BCBS - Anthem | Colorado | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - Anthem | Connecticut | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - Carefirst | Delaware | Blue Cross Blue Shield of Delaware: Providers | Password Protected, Contact carrier for billing guidelines, service request form available |
| BCBS - Carefirst | DC | Provider Services - CareFirst BlueCross BlueShield | Accept terms, click on table of contents, click on Radiology, No written policy |
| BCBS | Florida | BCBSF Medical Coverage Guidelines (MCG) | Click on Radiology, click on Bone Mineral Density Studies |
| BCBS | Georgia | BlueCross BlueShield of Georgia | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - HMSA | Hawaii | Medical Policies | Click on Bone (Mineral) Density Studies |
| BC - Premera | Idaho | Blue Cross of Idaho - Home Page | Click on Continue, click on Radiology, Click on Bone Mineral Density |
| BS Regence | Idaho | The Regence Group Medical Policy Manual | Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density |
| BCBS | Illinois | BCBSIL/Provider Medical Policies on Fyiblue | Click on I Agree, Search by 77080 - currently no written coverage policy |
| BCBS - Wellpoint (AKA Anthem) | Indiana | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - WellMark | Iowa | Wellmark Providers | Click on Medical Policies, accept terms, enter CPT 77080 |
| BCBS | Kansas | BCBSKS - Medical Review - Institutional - Medical Policies | Within search feature type in 77080, click on Medical Policy |
| BCBS - Anthem | Kentucky | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS | Louisana | BCBSLA - Medical Policy Coverage Guidelines | Password Protected, may or may not have a written coverage policy |
| BCBS - Anthem | Maine | Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - Carefirst | Maryland | Provider Services - CareFirst BlueCross BlueShield | Accept terms, click on table of contents, click on Radiology, No written policy |
| BCBS | Massachuettes | Medical Policies | Click on B, page down to Bone Densitometry |
| BCBS | Michigan | Blue Cross Blue Shield of Michigan - Welcome Providers | Password Protected, may or may not have a written coverage policy |
| BCBS | Minnesota | Blue Cross and Blue Shield of Minnesota | Accept terms, click view all active policies, no written policy on file |
| BCBS | Mississippi | Blue Cross & Blue Shield of Mississippi | Medical Policy Search | Click on view |
| BC - Anthem | Missouri | Anthem Medical Policies ^ Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS | Missouri | Blue Cross Blue Shield of Kansas City : BCBSKC Home | Password Protected, may or may not have a written coverage policy |
| BCBS | Missouri | BCBSMT Medical Policies | Accept terms, click on "B", page down to Bone Mineral Density |
| BCBS | Nebraska | BCBSNE - Medical Policy Disclaimer | Accept terms, no written coverage policy - check under Bone Mass Measurement |
| BCBS - Anthem | Nevada | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - Anthem | New Hampshire | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS - Horizon | New Jersey | https://services5.horizon-bcbsnj.com/eprise/main/horizon/tsnj/tsweb/Medical_Policies_Guidelines.html | Click on Medical Policies, accept terms, click on Alphabetical, click on B, page down to Bone Density Studies |
| BCBS | New Mexico | Welcome, Providers | Click on I Agree, Search by 77080 - currently no written coverage policy |
| BCBS-Western NY | New York | BlueCross BlueShield of Western New York Clinical Protocols | Select B - no written policy on file |
| BS of Northeastern | New York | BlueShield of Northeastern New York Clinical Protocols | Select B - no written policy on file |
| BCBS-Empire | New York | Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS-Excellus | New York | Excellus BlueCross BlueShield | Accept terms, type in search Bone Densitometry |
| BCBS | North Carolina | Medical policy search | Type in 77080 in search feature, click on PDF Bone Mineral Density |
| BCBS | North Dakota | BCBSND: Providers - Medical Policy | Accept terms, click on enter medical policy, click on "B", page down to Bone Density studies |
| BCBS - Anthem | Ohio | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS | Oklahoma | Health Insurance Offered by Anthem Blue Cross and Blue Shield | Click on I Agree, Search by 77080 - currently no written coverage policy |
| BCBS - Regence | Oregon | The Regence Group Medical Policy Manual | Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density |
| BC - Noetheastern | Pennsylvania | BCNEPA - Our Health Plans - Experimental/Investigative Medical Policies | No written policy |
| BCBS-Highmark | Pennsylvania | Highmark Medical Policy Search | Click on search by CPT 77080, click on Bone Mineral Density studies |
| BCBS-Capital | Pennsylvania | Providers - Main - www.capbluecross.com | Password Protected, may or may not have a written coverage policy |
| BCBS-Independence | Pennsylvania | Medical Policy | Accept terms, no written coverage policy - check under Bone Mass Measurement |
| BCBS | Rhode Island | Blue Cross & Blue Shield of Rhode Island - Sign In | Password Protect, may or may not have a written policy |
| BCBS | South Carolina | Welcome to SouthCarolinaBlues.com for Providers | Click on Medical Policies, right hand side, accept terms, click on "B" no written policy currently |
| BCBS - WellMark | South Dakota | Wellmark Providers | Click on Medical Policies, accept terms, enter CPT 77080 |
| BCBS | Tennessee | Providers - BCBST.com | Type in Bone Mass Measurement in search feature |
| BCBS | Texas | BCBSTX Providers Medical Policies on Fyiblue | Type in CPT code 77080, click on CPT search - no written policy |
| BCBS - Regence | Utah | The Regence Group Medical Policy Manual | Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density |
| BCBS | Vermont | Blue Cross Blue Shield Vermont: Home Page | Click on provider, password protected, may or may not have a written policy |
| BCBS - Anthem | Virginia | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BC- Premera | Washington | Premera Blue Cross - Reference Info,Medical Policies | Accept terms, no written coverage policy - check under Bone Mass Measurement |
| BS - Regence | Washington | The Regence Group Medical Policy Manual | Accept terms, click on table of contents, click on Radiology, click on Bone Mineral Density |
| BCBS | West Virginia | Mountain State BCBS - Medical Policy | No written policy |
| BCBS - Anthem | Wisconsin | Anthem Medical Policies and Clinical UM Guidelines | Accept terms, page down click search policies, type in Bone Density Measurement, Click on CG-RAD-18 |
| BCBS | Wyoming | BCBSWY: Providers | Password Protected, may or may not have a written coverage policy |
| Cigna | National | CIGNA Healthcare for Health Care Professionals - Coverage Positions | Click on "B", page down to Bone Mineral Density |
| Healthnet | Various States | Health Net Provider | Page down to Bone Mineral Density |
| Humana | National | Clinical & Healthcare Resources | No written policy |
| CMS (Centers for Medicare and Medicaid Services) | National | Centers for Medicare & Medicaid Services | click on search, select local, select state, select CPT 77080 |
| United Healthcare | National | UnitedHealthcare Online | Click on Medical Policies, accept terms, page down to Bone Densitometry |
Whats New in Policy Updates
Computed Tomography
Hospital Outpatient Reimbursements for Pelvic/Abdominal CT - January 2012 [PDF]
Professional Societies
Professional Societies Contact Information
- Academy of Molecular Imaging (310) 267-2614
- American Association of Orthopaedic Surgeons (847) 823-7186
- American College of Cardiologists (800) 253-4636
- American College of Obstetricians & Gynecologists (202) 638-5577
- American College of Radiologists (703) 648-8900
- American Council on Exercise (800) 825-3636
- American Society for Bone and Mineral Research (202) 367-1161
- American Society of Echocardiography (919) 861-5574
- Association for Ultrasound in Medicine (800) 638-5352
- International Society for Clinical Densitometry (860) 586-7563
- Society for Vascular Ultrasound (SVU) (301) 459-7550
- Society of Nuclear Medicine (703) 708-9000
- Society for Interventional Radiologists (703) 691-1805
