If you have scheduled a breast thermogram, please use this form in addition to the previous ones above. Each and every time you have a breast thermogram, you must complete this questionnaire: -BREAST THERMOGRAPHY QUESTIONNAIRE
Typically, thermography is not covered by insurance, but if you would like to inquire with your insurance company, the CPT Code for Thermography is 93740. The ICD9 Code for Breast Thermography is 88.85