CPT 77067: Screening Mammography, Bilateral
Screening mammography, bilateral (2-view study of each breast), including computer-aided detection when performed.
Why CPT 77067 Claims Get Denied
Claims billed under CPT 77067 are frequently denied or downcoded for the following reasons. Understanding these patterns helps your practice reduce denial rates and recover revenue faster.
Frequency exceeds annual screening limit
Patient age does not meet screening criteria per payer
Billed as screening but diagnostic findings present
Missing appropriate screening diagnosis code
Billing Tips for CPT 77067
Under the ACA, annual screening mammography is covered without cost sharing for women 40+. Use Z12.31 for screening encounter. If abnormalities are found and additional views are needed, bill diagnostic mammography codes (77065-77066) separately. Medicare covers annual screening for women 40+.
Documentation Requirements
To support a clean claim for CPT 77067, your clinical documentation should include:
Provider order or self-referral per state law
Patient age documented
Bilateral images obtained
Radiologist interpretation with BI-RADS assessment
Recommendation for follow-up if needed
Reduce CPT 77067 Denials by 60%
RediClaim's pre-submission scrubber catches documentation gaps and coding errors before you submit, while the appeal generator handles denials that slip through.