Reimbursement

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The Dilon MBI study is generally covered by Medicare/Medicaid and some private carriers in the U.S. The coverage for MBI in the world varies.  Please contact the insurance carrier for details.

Insurance reimbursement in the U.S. is achieved through standard nuclear medicine CPT codes. Average reimbursement rates range from $200 to $700 depending on geographic region and the individual insurance policies for reimbursement.

Billing Codes in the U.S.

For Breast Tumor Imaging Procedures & Imaging Agent

  • 78800 – Tumor localization (limited area)
  • 78801 – Tumor localization (multiple areas)
  • A9500 – Imaging agent; Technetium TC 99M Sestamibi (formerly trade named Miraluma)

Dilon is happy to provide support to MBI users and patients through our reimbursement tools kit. The tools kit covers the following:

  • CPT coding guide
  • Letter templates for appeals
  • A concise guide to the medical literature