Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography

This policy covers breast ultrasonography, breast MRI, and ductography for specified clinical indications: ultrasound for guidance of interventions, evaluation of palpable or mammographically detected masses (especially in women <30, pregnant, or lactating), implant assessment, and select diagnostic clarifications; MRI is limited to selective uses such as inconclusive standard work-up, distinguishing scar from tumor post‑op, positive axillary nodes without known primary, implant rupture, and pre-treatment extent-of-disease assessment in known malignancy; ductography is indicated for abnormal nipple discharge and suspected intraductal papilloma. Treating provider orders/referrals and physician supervision (general for ultrasound/MRI, personal for ductography) are required except for hospital-based radiologists performing inpatient or outpatient studies. Routine concurrent use of ultrasound with diagnostic mammography is discouraged and separate transportation payments are restricted unless statutory certification conditions are met.