77067ImagingCPT

Screening Mammogram (Bilateral)

Last verified: March 2026

What is this procedure?

Bilateral screening mammography for breast cancer detection in asymptomatic women. Digital breast tomosynthesis (3D mammography) may be included. Recommended annually for women age 40 and older per current guidelines. Most insurers cover without prior authorization under ACA preventive care mandates.

Does this require prior authorization?

Usually not required, but check your specific plan

Medical Necessity Tips

What clinical evidence supports approval

  • ACA-compliant plans must cover screening mammograms without cost-sharing
  • Diagnostic mammograms (following abnormal screening) may require authorization
  • Document family history and risk factors for enhanced screening protocols
  • BRCA mutation carriers may qualify for additional MRI screening

What to Do If Denied

If your screening mammogram (bilateral) is denied, you have the right to appeal. Most denials are overturned on appeal when proper documentation is provided.

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This information is for educational purposes only and is not medical, legal, or financial advice. Coverage decisions depend on your specific plan, insurer, and clinical circumstances. Always verify with your insurance company and healthcare provider.

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