National Coverage Analysis (NCA) Tracking Sheet

Breast Biopsy

CAG-00040N

Issue

Percutaneous image guided breast biopsy is sometimes used as an alternative to needle localization and open excisional biopsy to evaluate nonpalpable mammographically detected breast lesions. Currently carriers vary in their treatment of this procedure. HCFA is developing appropriate coverage criteria.

Benefit Category

Ambulatory Surgical Center Facility Services
Inpatient Hospital Services
Outpatient Hospital Services Incident to a Physician's Service
Physicians' Services

Requestor Information

Requestor Name Requestor Letter
Internal, United States Surgical, Tyco Healthcare Group N/A
N/A

Important Dates

Formal Request Accepted and Review Initiated
06/29/1999
Expected NCA Completion Date
12/14/1999
Public Comment Period
07/29/1999 - 08/27/1999
Proposed Decision Memo Due Date
Proposed Decision Memo Released
Proposed Decision Memo Public Comment Period
Decision Memo Released
12/07/1999

Contacts

Lead Analysts
Sharon Hippler
Lead Medical Officers
John Whyte, MD, MPH

Medicare Benefit Category Determination Date

Actions Taken

September 13, 1999

Receipt of duplicate request from United States Surgical which provided additional information to inform the coverage process

December 7, 1999