Summary & Overview
CPT 77054: Ductogram (Galactogram) Radiological Supervision and Interpretation
CPT code 77054 denotes the radiological supervision and interpretation of a ductogram (galactogram) performed on multiple breast ducts. The procedure is clinically important for the evaluation of pathologic nipple discharge and for imaging intraductal lesions that can include benign papillomas, ductal ectasia, fibrocystic changes, and ductal carcinoma. Nationally, ductography remains a focused diagnostic tool within breast imaging pathways when ductal-origin discharge or ductal abnormality is suspected.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for when CPT code 77054 is used, standard sites of service, and common billing modifiers associated with radiology interpretation services. The publication summarizes prevailing payer coverage patterns, typical documentation and supervision elements relevant to interpretation services, and points of coding clarity for multi-duct ductography claims.
This resource is intended for billing staff, radiology administrators, and clinicians involved in breast imaging workflows. It highlights the clinical indications that commonly prompt use of the code, outlines what to expect in payer policies at a national level, and identifies areas where documentation and coding specificity influence claim processing and reimbursement. Data not available in the input.
Billing Code Overview
CPT code 77054 describes the radiological supervision and interpretation of a ductogram (galactogram) for multiple breast ducts. A ductogram is an imaging procedure that visualizes the breast ductal system and is used to evaluate causes of nipple discharge and to detect ductal pathology such as ductal ectasia, intraductal papillomas, fibrocystic change, and ductal carcinoma.
Service Type: Diagnostic radiology — breast ductal imaging (ductogram/galactogram)
Typical Site of Service: Outpatient radiology department or ambulatory imaging center, and may also be performed in hospital outpatient settings when radiology services are provided for symptomatic breast evaluation.
Clinical & Coding Specifications
Clinical Context
A 42-year-old woman presents to a breast clinic with persistent unilateral serous nipple discharge from the left breast for three weeks. Clinical breast exam identifies no palpable mass but the discharge is spontaneous and single-duct. Prior diagnostic mammography and targeted ultrasound did not show a discrete intraductal mass. The breast surgeon refers the patient for a ductogram/galactogram to evaluate the ductal system and localize an intraductal lesion.
The procedure is performed in an outpatient radiology suite. The patient is positioned in a mammography unit; the affected duct is cannulated at the nipple, contrast is gently injected, and spot radiographs are obtained to visualize the ductal tree. Radiological supervision and interpretation are provided by a board-certified radiologist. Findings guide subsequent management: if an intraductal filling defect is identified, surgical consultation for duct excision (microdochectomy) is arranged; if ductal ectasia or benign changes are seen, conservative management or targeted follow-up is planned.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the radiologist interpretation (professional component) separate from technical imaging resources. |