CPT® Code. Definition. 19281. Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance +19282...each additional lesion, including mammographic guidance (List separately in addition to code for primary procedure) 19283
Placement of breast localization device (s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance ...each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
The new biopsy codes for percutaneous image-guided needle core breast biopsies include Mammotome, ATEC, ABBI, and other vacuum-assisted or rotating devices. These new codes include the use of imaging guidance; placement of a localization device such as a metallic clip, pellet, etc (if performed); and specimen imaging (if performed).
• placement of a clip or radioactive seed in the breast as a stand-alone procedure; • placement of a localization device following fine-needle aspiration of the breast (if permitted by payer guidelines); and • placement of fiducial markers. Unlike the biopsy codes just reviewed, there are codes for mammographic-guided localization procedures.
19081If a percutaneous breast biopsy is performed using both stereotactic and tomosynthesis imaging guidance, CPT code 19081 (Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ...
Needle localization (also called wire localization) is a procedure done before breast cancer surgery to find where the breast abnormality is (The wire marks the spot) so that the surgeon knows exactly what tissue to take out. This procedure is done by mammogram or ultrasound guidance.
Radar breast localization can help your surgeon precisely locate and surgically remove your breast abnormality, while helping to spare healthy tissue. A tiny metal reflector is implanted into the abnormal breast tissue.
Typically, a tiny tissue marker (also called a clip) is put into the area where the biopsy is done. This marker will show up on mammograms or other imaging tests so the exact area can be located for further treatment (if needed) or follow up.
General Information: Pre-Surgical Localization procedure is performed prior to your surgery. This is done to assist the surgeon to find the area to be removed. We will place a wire that has a hook on the end to stay in place, and will be localized by the surgeon in the operating room.
A wire localization is done by radiology to help your surgeon to locate the area of breast tissue that needs to be removed. o Before your surgery, on the same day, a radiologist will take pictures of your breast using the mammogram or ultrasound.
After consultation with your breast surgeon, the radiologist can mark the area to be removed during surgery either with a small metallic reflector clip called a SAVI SCOUT or with a thin wire. A SAVI SCOUT can be placed before the day of your surgery; a wire must be placed on the morning of the surgery.
Listen to pronunciation. (NEE-dul LOH-kuh-lih-ZAY-shun) A procedure used to mark a small area of abnormal tissue so it can be removed by surgery. An imaging device is used to guide a thin wire with a hook at the end through a hollow needle to place the wire in or around the abnormal area.
A wire localization biopsy is a procedure that uses a fine wire to mark the exact location of a lump or abnormality. It is done before a surgeon does an excisional biopsy to remove the lump. This procedure may also be called wire localization, fine-wire localization or needle localization.
A tissue marker (or marker clip) is placed in your breast after a breast biopsy to help locate the site for future reference. This will be done by a breast radiologist at the time of your needle biopsy or at a later date.
A small metal clip may be inserted into the breast to mark the site of biopsy in case the tissue proves to be cancerous and additional surgery is required. This clip is left inside the breast and is not harmful to the body. If the biopsy leads to more surgery, the clip will be removed at that time.
After removing the tissue samples, the doctor may leave a tiny clip or marker, made of surgical-grade material, to identify the biopsy site. This will be visible on a mammogram. The marker points out the exact site of the biopsy so that a doctor can find it again easily if they need to.
The wire is taped to your skin. You may feel the wire in your breast, but generally it is not painful. After the needle localization has been completed, you will be sent to surgery. The surgeon will use the wire, as a guide, to find the abnormal area in your breast.
A wire localization biopsy is a procedure that uses a fine wire to mark the exact location of a lump or abnormality. It is done before a surgeon does an excisional biopsy to remove the lump. This procedure may also be called wire localization, fine-wire localization or needle localization.
A wire guided excision biopsy means putting a thin wire into the breast tissue to show a surgeon the exact area to remove. Your surgeon might use this if a breast x-ray (mammogram) or breast ultrasound has shown an abnormal area, but they can't feel anything when they examine you.
This procedure takes about 30 minutes and will usually be on the day of surgery. We suggest that a friend or partner drives you to the hospital from our rooms.
If two lesions are biopsied using different imaging modalities, whether in the same or opposite breast, two base codes are assigned, one for each modality utilized. The add-on codes may be assigned only when the same modality is utilized for separate and distinct lesions in the same breast.
Percutaneous breast biopsies can be performed utilizing various techniques, including needle core, stereotactic, rotating biopsy device, or vacuum assisted (eg, Mammotome). Ultrasound, MRI, and stereotactic guidance typically are employed to perform breast biopsies, so the new codes address only these imaging modalities.
Previously independent diagnostic testing facilities could bill for the imaging guidance of percutaneous breast procedures, but most contractors will not permit them to bill for the new comprehensive codes. Currently, there is no authoritative guidance from the CMS to address this problem.
In the rare instance where clip removal is performed as a stand-alone procedure, it should be reported with the unlisted code 19499 since there isn’t a specific code for this procedure.
There are no breast biopsy procedure codes for mammographic- or CT-guided procedures, and payer guidelines should be consulted prior to code submission if these services are performed. One option for CT-guided procedures would be to assign 19499 and 77012.
Biopsies from a separate lesion can be coded separately, so it’s important that the physician documentation clearly defines each separate lesion. The National Correct Coding Initiative (NCCI) edits bundle the following procedures and codes into 19081 to 19086: • fine-needle aspirations (10021 and 10022);
If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with radiologic guidance (e.g., 76942, 77012, 77021, 77031, 77032), the physician should not separately report a post procedure mammography code (e.g., 77051, 77052, 77055-77057, G0202-G0206) for the same patient encounter. The radiologic guidance codes include all imaging required to perform the procedure#N#DOES THIS HELP???
AMA and ACR have said for several years now that it is appropriate to code for the post procedure mammogram in most cases as it is a separate exam. There is even an MQSA approved assessment category for post procedure mammograms for marker placement (approved in 2003).
Blue Cross Blue Shield of North Dakota (BCBSND) has identified an increase in providers billing CPT 19499, Unlisted Procedure, Breast. Review of medical records identified 19499 was being used for breast biopsies performed with stereotactic and tomosynthesis image guidance.
While reimbursement is considered, payment determination is subject to, but not limited to:
Reimbursement policies are intended only to establish general guidelines for reimbursement under BCBSND plans. BCBSND retains the right to review and update its reimbursement policy guidelines at its sole discretion.