Cytological Examination of Breast Fluids for Cancer Screening or Diagnosis – Commercial and Individual Exchange Medical Policyopen_in_new

UnitedHealthcare considers breast ductal lavage, ductal fluid/nipple aspiration with cytology, and fiberoptic ductoscopy (with or without lavage) unproven and not medically necessary — and therefore not covered — for breast cancer screening, diagnosis, or to guide surgery due to low sensitivity, high sample inadequacy, limited/heterogeneous evidence, and no demonstrated improvement in clinical outcomes. Coverage must follow the member’s specific benefit plan and applicable federal/state mandates (member plan governs if conflict); no specific CPT codes are listed (unlisted 19499 noted) and the policy provides no special documentation requirements.

"None."

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