Summary & Overview
HCPCS S8080: Scintimammography (Unilateral Breast) including Radiopharmaceutical
HCPCS Level II code S8080 denotes scintimammography (radioimmunoscintigraphy) of a single breast, including the radiopharmaceutical supply. This nuclear medicine diagnostic procedure is used to image and help characterize suspicious breast lesions when other modalities are inconclusive or contraindicated. Nationally, the code is relevant for facilities that offer specialized breast imaging and for payers evaluating coverage and utilization of adjunctive diagnostic tools.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical purpose of the service, typical sites of care, and which payers commonly adjudicate claims for this code. The publication outlines benchmark considerations, common billing modifiers used with imaging services, and clinical context for when scintimammography is applied.
This summary serves clinicians, billing professionals, and policy analysts seeking a national perspective on S8080, with guidance on where the service is performed and how it fits into diagnostic pathways for breast lesion evaluation. Data not available in the input is noted where applicable in the full publication.
Billing Code Overview
HCPCS Level II code S8080 represents scintimammography (radioimmunoscintigraphy of the breast), unilateral, including supply of radiopharmaceutical. This service involves nuclear medicine imaging of a single breast using a radiopharmaceutical to detect or characterize breast lesions.
-
Service type: Nuclear medicine diagnostic imaging
-
Typical site of service: Outpatient imaging center or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman aged 40–75 presenting with a suspicious breast mass or complex imaging findings (mammography and ultrasound inconclusive) and a history of prior breast surgery or dense breast tissue limiting conventional imaging. The clinician orders unilateral scintimammography (S8080) to localize metabolically active tumor tissue using a radiolabeled agent and to assist in differentiating benign from malignant lesions when conventional imaging is equivocal. The workflow includes pre-procedure physician consultation, informed consent, administration of the radiopharmaceutical, gamma camera imaging of the affected breast, image processing and interpretation by a nuclear medicine physician, and documentation of findings in the chart. Supplies of the radiopharmaceutical are included in the service description. Results inform surgical planning, biopsy targeting, or additional imaging; a separate professional component may be billed if interpretation is performed by a different provider than the imaging facility.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation of the scintimammography separate from technical imaging supplies/equipment. |