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S0613 Ann breast examination

S Codes

Also known as: annual breast exam, CBE

Annual breast examination. Yearly clinical breast examination for cancer screening.

In Plain Language

yearly breast check; breast screening exam

Clinical Context

Preventive screening of breast tissue for lumps, asymmetry, or other abnormalities. Part of comprehensive women's health examination, complementary to mammography.

RVU Information

CPT S0613 does not have a physician work RVU assigned by CMS. This is typical for supply, drug, and equipment codes — reimbursement is based on Average Sales Price (ASP), fee schedules, or payer contracts rather than the RVU system.

Billing & Documentation

S-codes are used by private payers (not Medicare) for services without a standard CPT or HCPCS code. Coverage varies significantly between insurers. Verify payer acceptance before billing and document medical necessity thoroughly.

Specialties

GynecologyPrimary CareOncology

Frequently Asked Questions

What is CPT code S0613?

CPT S0613 (Ann breast examination) is a S Codes code. Annual breast examination. Yearly clinical breast examination for cancer screening.

Is S0613 covered by insurance?

S0613 is a temporary HCPCS code. Coverage varies by payer and may change when permanent codes are assigned. Preventive screening of breast tissue for lumps, asymmetry, or other abnormalities. Part of comprehensive women's health examination, complementary to mammography.

When is CPT S0613 used?

Preventive screening of breast tissue for lumps, asymmetry, or other abnormalities. Part of comprehensive women's health examination, complementary to mammography.

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CPT® is a registered trademark of the American Medical Association. Data sourced from CMS Physician Fee Schedule RVU26A. Descriptions, synonyms, and clinical context are original content by RVU Edge.