Summary & Overview
CPT 0694T: Intraoperative 3D Imaging of Breast or Axillary Lymph Node Specimen
CPT code 0694T represents intraoperative three-dimensional imaging and reconstruction of breast or axillary lymph node tissue specimens, including automatic specimen reorientation and a provider interpretation with report. The code captures a technology-enabled pathology imaging service performed during operations such as mastectomy and is relevant for surgical oncology workflows and perioperative pathology decision-making.
Key payers in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service captured by the code, typical sites of service, and payer coverage context. The publication summarizes how the code fits into surgical and pathology service lines, highlights common use cases in intraoperative specimen assessment, and outlines which benchmarks and policy updates payers often consider when evaluating coverage for technology-driven intraoperative diagnostic services.
This resource provides clinical context for billing teams, coding specialists, and policy analysts who need clear, national-level information on the service definition, expected site of service, and where to look for payer-specific coverage details. Data not available in the input for related taxonomies, specific ICD-10 pairings, and utilization benchmarks.
Billing Code Overview
CPT code 0694T describes intraoperative acquisition and 3D reconstruction of a breast or axillary lymph node tissue specimen during an operation such as mastectomy. The service includes automated specimen reorientation capability, interpretation by the provider, and a report of findings.
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Service type: Intraoperative 3D specimen imaging and reconstruction with interpretation
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Typical site of service: Operating room or intraoperative setting within a hospital or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 56-year-old female undergoing mastectomy for biopsy-proven invasive ductal carcinoma presents to the operating room for definitive surgery. During the procedure, the surgeon excises the breast tissue or sentinel/axillary lymph node specimen and requests intraoperative imaging and three-dimensional reconstruction of the specimen to confirm margins, specimen orientation, and correlation with preoperative imaging. The imaging system automatically reorients the specimen, generates multiplanar 3D reconstructions, and the interpreting provider (radiologist or pathologist trained in intraoperative specimen imaging) reviews images and issues an intraoperative interpretation and report. The typical clinical workflow includes specimen receipt in the operating suite or adjacent radiology/pathology suite, placement in the 3D imaging device, automated reorientation and acquisition of volumetric images, real-time review with the surgical team as needed, and documentation of findings in the operative record and imaging report. Typical site of service is the hospital operating room with imaging performed in the OR or an immediately adjacent intraoperative imaging suite; the service is frequently used during mastectomy, lumpectomy with margin assessment, and axillary lymph node evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting professional component of the imaging/reporting service separate from technical equipment. |
TC | Technical component | Use when billing only the technical component (equipment, technologist) of the imaging service. |
62 | Two surgeons | Use when two surgeons with distinct specialties work together as primary surgeons during the operative session that includes specimen imaging. |
78 | Unplanned return to the operating room for related procedure during postoperative period | Use if the patient returns to the OR unexpectedly for a related procedure where repeat specimen imaging is performed. |
22 | Increased procedural services | Use when work required for imaging/reconstruction is substantially greater than typical and documentation supports increased complexity. |
52 | Reduced services | Use when the imaging service is partially reduced or not performed to full extent compared with the full procedure descriptor. |
53 | Discontinued procedure | Use when the imaging process was started but discontinued before completion for documented clinical reasons. |
55 | Postoperative management only | Use when the surgeon performs only postoperative management of the patient and not the intraoperative service itself; applicable in team-surgery contexts. |
56 | Preoperative management only | Use when the surgeon performs only preoperative care of the patient, not the intraoperative imaging service. |
78 | Return to OR (duplicate listed for emphasis) | See above. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | General Surgery | Surgeons performing mastectomy or axillary procedures that request intraoperative specimen imaging. |
207XS0111X | Breast Surgery | Surgeons specializing in breast procedures commonly involved in specimen imaging workflows. |
207Q00000X | Surgical Oncology | Surgical oncologists who perform tumor resections and use intraoperative imaging for margin assessment. |
2085R0206X | Diagnostic Radiology | Radiologists who interpret intraoperative specimen imaging and provide the formal report. |
207K00000X | Pathology | Pathologists who may participate in specimen orientation and correlation with imaging and pathology grossing. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
C50.911 | Malignant neoplasm of unspecified site of right female breast | Common indication for mastectomy with intraoperative specimen imaging to assess margins and specimen orientation. |
C50.912 | Malignant neoplasm of unspecified site of left female breast | Same clinical relevance for left-sided breast cancer procedures requiring specimen imaging. |
C50.929 | Malignant neoplasm of unspecified site of breast, unspecified | General breast cancer diagnosis where intraoperative specimen imaging may be used. |
C50.111 | Malignant neoplasm of central portion of right female breast | Tumors in specific breast locations where 3D specimen imaging assists margin assessment. |
C77.3 | Secondary and unspecified malignant neoplasm of axillary and upper limb lymph nodes | Relevant when axillary lymph node excision is performed and nodes are imaged intraoperatively. |
Z90.13 | Acquired absence of right breast and nipple | Relevant in reconstructive or completion procedures where specimen orientation or re-excision imaging may be needed. |
D05.10 | Unspecified type of ductal carcinoma in situ of right breast | DCIS treated with lumpectomy/mastectomy where intraoperative specimen imaging can guide margin assessment. |
N63 | Unspecified lump in breast | Diagnostic procedures or excisions where intraoperative specimen imaging may be used for localization and confirmation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19303 | Mastectomy, simple, complete | Primary surgical procedure during which intraoperative 3D specimen imaging (0694T) may be performed to assess margins and specimen orientation. |
19301 | Partial mastectomy (lumpectomy), tumor excision | Breast-conserving surgery often paired with intraoperative specimen imaging for margin evaluation and 3D specimen correlation. |
38900 | Biopsy or excision of lymph node(s); open, deep axillary or intra-thoracic | Surgical nodal procedures that may be accompanied by 3D imaging of excised lymph node specimens for orientation and assessment. |
88300 | Level I surgical pathology gross and microscopic examination | Pathology gross evaluation and subsequent microscopic pathology are subsequent steps after intraoperative specimen imaging and orientation. |
76098 | Radiologic guidance for specimen radiography during surgery (separate procedure), including imaging and interpretation | Conventional specimen radiography is an alternative or adjunct to advanced 3D specimen imaging; used in workflows when 2D specimen radiographs are obtained intraoperatively. |