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    Breast Cancer Care

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      • Why MBI?
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    Referral Information for non-Mayo Clinic Health System providers

    A primary care provider must order the MBI. The referring provider is then notified when the MBI is scheduled.

    Telephone and fax numbers

    • Center for Breast Care — 608-392-9822
    • Center for Breast Care referral questions — 608-392-6464 (Robin Manke)
    • Patient Referral Services — 608-392-9816
    • Patient Referral Services fax — 608-392-9814

    Important documents

    • Patient Referral Form — Print, complete and fax to Patient Referral Services to refer a patient for an MBI
    • MBI Information for Referring Providers

    Prior authorization or pre-approval CPT codes

    • 78800 (Radiopharmaceutical Localization of Tumor, Limited Area)
    • A9500 (Supply of Radiopharmaceutical Imaging Agent - Technetium TC-99m Sestamibi, per Dose)

    Communication with referring providers

    • Referring providers receive MBI results by fax.
    • If results are positive, the Radiology/Breast Imaging Department contacts the patient to offer and schedule additional diagnostic imaging.
    • Any additional report(s) are faxed to the referring provider.

    Relevant webpages to share with patients

    • Mayo Clinic Health System Center for Breast Care
    • Why MBI
    • Facts about MBI

    Not all treatments, tests and services are available at all Mayo Clinic Health System locations. Check with your preferred location in advance.

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