Cytological Examination of Breast Ductal Fluids (Ductal Lavage, Nipple Aspirate Fluid, Fiberoptic Ductoscopy)
This Tennessee-specific UnitedHealthcare medical policy governs use of cytological examination of breast ductal fluids (ductal lavage, nipple aspirate fluid, and fiberoptic ductoscopy) for breast cancer screening, diagnosis, and as alternative tools to guide surgery for Medicaid and CoverKids in Tennessee. It describes coverage rationale, evidence review, applicable CPT codes, and related guidance.
Supporting Information Updated: Description of Services, Clinical Evidence, FDA, and References sections updated to reflect current information.
Coverage Summary
Overview: This Tennessee-specific policy (Policy Number: CSO29TN.S, Effective 2025-09-01) governs cytologic examination of breast ductal fluids obtained by ductal lavage, nipple aspirate fluid (NAF), and fiberoptic ductoscopy (FDS) for Medicaid and CoverKids. The policy stance: these procedures are considered unproven and not medically necessary / not covered for breast cancer screening, diagnosis, or as alternative tools to guide surgery.
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