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STEREOTACTIC, ULTRASOUND & MRI GUIDED BREAST BIOPSY (MIBB)

Triple-S will consider for payment Stereotactic-guided non-palpable breast lesions that are seen only on mammography (not well visualized on Ultrasound).
Triple-S will consider for payment MRI- guided non-palpable breast lesions that are seen only on MRI  (not well visualized on Ultrasound or mammography).

Triple-S will consider for payment Ultrasound-guided of palpable or non-palpable high-risk breast lesion(s) or masse(s).

Triple-S considers MIBB  is an invasive procedure, which will limit the payment coverage to those surgeons and radiologists who submit evidence of training and experience as established by the «Board of Regents of the American College of Surgeons «and by the» Board of Chancellors of the American College of  Radiology «in the following document: Physician Qualifications for stereotactic breast biopsy: a revised statement. Bulletin of the American College of Surgeons. Vol. 83, No.5, January 2014, and ACR Practice Guideline for the performance of Stereotactic guided Breast interventional procedure of 1996, revised in 2009.

Indications:

a.    Indications – the main use of this technology is obtaining tissue for diagnosis of non-palpable breast lesions. Within this framework, the main indications are the following:

• non-palpable lesions that are highly suggestive of malignancy
• Indeterminate lesions
• Benign lesions associated with multiple risk factors in the patient
• Lesions with well-defined solid mass characteristics, solid lesions with indistinct or spiculated  margins and micro-calcifications

b.    Limitations – Triple-S will consider for payment the stereotactic breast biopsy when the services are rendered in the following places:

• Hospital (inpatient)
• Hospital (outpatient)
• Ambulatory surgery center
• Office

787-277-6653 787-474-6326