Frequently Asked Questions

faq-2

Are billing codes established for Molecular Breast Imaging (MBI) in the U.S.?

Billing codes have been established for nuclear breast imaging procedures and the uptake agent. They are:

  • 78800 Tumor localization (limited area)
  • 78801 Tumor localization (multiple areas)
  • A9500 Imaging agent – Technetium Tc 99m (Sestamibi).

Does insurance cover BSGI/MBI in the U.S.?

Insurance policies and procedures can vary. Check with your insurance provider.

What is the reimbursement rate for BSGI/MBI in the U.S.?

Average reimbursement rates range from $200 to $700 depending on geographic region and payers’ policies for reimbursement.

What is the advantage of MBI?

Clinical studies have shown that MBI can detect cancers missed by mammography and ultrasound while leading to fewer benign biopsies than MRI. This seems to be especially true for patients with dense breasts and patients who have types of cancer that are difficult to detect, like lobular carcinoma

Does the Dilon MBI procedure ever produce false positives?

The Dilon MBI procedure produces a low number of false-positive results (a positive test when no cancer is present). Like all breast imaging studies, MBI will have some false-positives, but the results of clinical studies suggest that MBI has fewer false-positives than other imaging studies.

Many of the benign conditions that cause false-positive MBI results are considered high-risk and are commonly removed by a surgeon. For example atypical ductal hyperplasia, lobular carcinoma in-situ, and atypical papillomas are often positive by MBI

Does the Dilon MBI procedure ever produce false negatives (miss cancers)?

Like all imaging studies, MBI will be false negative in some cases, but the results of clinical studies suggest MBI has fewer false negatives than mammography or ultrasound, especially in patients with dense breasts.

Will MBI ever replace mammography as a screening tool?

Mammograms will remain the gold standard in breast cancer screening and will continue to be the standard first step in breast cancer detection. However MBI, MRI and ultrasound will continue to serve special populations of patients who need tests beyond a mammogram.

Will MBI be cost-effective in my practice or breast center?

Yes. The Dilon Molecular Imaging system is easy to incorporate into a practice or breast center because of the relatively low acquisition cost, and there is no need for build-out or special facilities.

For the breast cancer patient: How useful is MBI in detecting recurrent breast cancer compared to other imaging modalities?

MBI is an accurate and non-invasive method for the detection of new malignancies in patients with a history of breast cancer; specifically because of its ability to differentiate normal scar tissue from cancer. Scar tissue can make finding cancers by mammography or ultrasound difficult but does not affect the sensitivity of MBI.

How much radiation is involved in MBI?

MBI involves the injection of a dose to the patient that is comparable with or lower than that of other diagnostic imaging procedures.

Is the tracing agent safe for patients?

The radiopharmaceutical used in the MBI procedure has been used safely for more than 20 years in cardiac stress tests. The majority of the drug leaves your body within hours after administration, and is completely eliminated within 30 hours. For additional information about the pharmaceutical risks of Technetium TC 99m Sestamibi please visit Cardiolite Website.

How long does it take for the tracing agent to work?

After the patient is intravenously injected with a small dose of sestamibi, imaging can begin immediately and continue as needed for approximately 90 minutes. After about 90 minutes, the washout of sestamibi may compromise image quality.

How long does the MBI procedure take?

In general, four images are taken — two for each breast. Each view takes about 5 – 10 minutes to image. The procedure lasts from 45 minutes to an hour for all of the images to be completed.

On what percentage of patients in my practice can I use BSGI/MBI?

While dependent on your population, in general, 10 percent to 25 percent of your patients could fall into one of the following categories:

Go to Clinical Indications for MBI

How does MBI differ from other breast imaging tests?

MBI differs from other breast imaging modalities such as mammography and ultrasound in that it is a functional (metabolic) test rather than a structural (anatomic) test. Structural or anatomical imaging takes a picture of the tissue within the breast, both normal and abnormal, like cysts, glands, ducts, tumors or scar tissue. These test are trying to find something that “looks” suspicious. MBI as a functional imaging procedure images cellular metabolism allowing physicians to see the metabolic activity of the tissue, and see if the tissue “acts” suspicious which can help to differentiate benign from malignant tissue since they often look alike on mammography or ultrasound.