Breast Imaging Mammography/Breast Echography (Sonography)/Breast MRI/Ductography
J15 · Effective Oct 1, 2015
8 active Medicare policies list N63.42, and 4 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.
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J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
National · Effective Dec 4, 2025
J6 · Effective Apr 1, 2026
National · Effective Oct 1, 2026
4 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of N63.42 |
|---|---|---|
| Breast Biopsy Procedures | Apr 26, 2023 | Covered |
| Breast Ductal Lavage and Fiberoptic Ductoscopy | Jul 12, 2023 | Covered |
| Policy | Effective | Status of N63.42 |
|---|---|---|
| Mastectomy for Gynecomastia | Apr 15, 2026 | Covered |
| Policy | Effective | Status of N63.42 |
|---|---|---|
| Transvaginal Ultrasound, Non-Obstetrical |
| Mar 15, 2026 |
| Not covered |