Breast Biopsy Procedures

Aetna covers minimally invasive image‑guided breast biopsy procedures — including ABBI, MRI‑guided core‑needle biopsy, stereotactic core‑needle biopsy, and radioactive seed localization/ROLL — as medically necessary alternatives to needle‑localization core surgical biopsy for mammographically identified non‑palpable or difficult‑to‑palpate lesions. Image‑guidance is not required for larger, fixed palpable lesions (palpation‑guided biopsy is sufficient), and other unlisted image‑guided techniques (e.g., PET‑guided), 3D volumetric imaging/reconstruction, magnetic seeds (Magseed), SAVI SCOUT, and the MarginProbe are considered experimental/investigational and not covered.

"Minimally invasive image-guided breast biopsy procedures are medically necessary as alternatives to needle localization core surgical biopsy (NLBx) in members with abnormalities identified by mammo..."