Summary & Overview
CPT 77053: Radiological Supervision & Interpretation of Ductogram, Single Duct
Headline: CPT code 77053: Radiological Supervision and Interpretation of a Ductogram for a Single Duct
Lead: CPT code 77053 covers the radiological supervision and interpretation of a ductogram (galactogram) performed on a single breast duct to evaluate nipple discharge and related intraductal abnormalities. This targeted diagnostic imaging procedure fills a specific clinical need in breast care by providing detailed ductal visualization that can distinguish ductal ectasia, intraductal papillomas, fibrocystic change, and suspicious intraductal lesions.
Why it matters: Nationally, ductography remains an important adjunct in the diagnostic pathway for patients with pathologic nipple discharge. Accurate coding of CPT code 77053 ensures clear documentation of the interpreting physician’s professional service for single-duct ductography and supports appropriate claims processing across major payers.
Payers covered: The analysis addresses coverage considerations for Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
What readers will learn: This publication explains the clinical context and service delivery settings for CPT code 77053, summarizes typical sites of service, and outlines which payers are included in the coverage review. It provides benchmarks and policy-oriented observations relevant to billing and claims processing for single-duct ductography, and highlights areas where policy clarifications or documentation specificity commonly affect reimbursement outcomes.
Billing Code Overview
CPT code 77053 describes the radiological supervision and interpretation of a ductogram (galactogram) for a single duct. A ductogram is an imaging procedure used to evaluate the breast ductal system and is particularly useful for investigating nipple discharge and suspected intraductal pathology.
Service type: Radiology — Diagnostic Imaging, Fluoroscopic Breast Ductography
Typical site of service: Outpatient radiology suite, hospital imaging department, or breast imaging center
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 45-year-old woman presents to a breast specialty clinic with persistent unilateral bloody nipple discharge from a single duct for 3 weeks. History and clinical breast exam localize the discharge to a single ductal orifice without a palpable mass. The breast surgeon orders image-guided evaluation. In the radiology suite the patient undergoes a ductogram/galactogram: under sterile technique a lacrimal probe or cannula is inserted into the involved ductal orifice, contrast is gently instilled, and targeted mammographic views are obtained. The procedural workflow includes informed consent, duct cannulation by the breast surgeon or trained proceduralist, mammographic image acquisition by the radiology technologist, and radiological supervision and interpretation by a board-certified diagnostic radiologist. Images are reviewed for ductal filling defects, intraductal masses such as papillomas, ductal ectasia, or signs suspicious for malignancy. Results guide next steps such as targeted ultrasound, duct excision (microdochectomy), core biopsy, or close imaging follow-up. Typical site of service is an outpatient radiology department or breast center; the imaging component is reported by the radiologist using 77053 for a single duct.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When reporting only the radiologists interpretation/supervision separate from the technical imaging costs |