2025 CPT code 19285
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Breast Surgery Feed
Percutaneous placement of a breast localization device (e.g., clip, metallic pellet, wire/needle, radioactive seeds) for the first lesion, using ultrasound guidance.
Modifiers may apply depending on the circumstances of the procedure (e.g., 50 for bilateral procedures, 59 for distinct procedural services, 76 for repeat procedure). Consult the current CPT guidelines for further clarification.
Medical necessity is established when a patient presents with a suspicious breast lesion requiring biopsy or surgical excision.The accurate localization device placement is crucial to minimize surgical exploration and improve the procedure’s precision.
The physician is responsible for all aspects of the procedure, including patient preparation, image guidance (ultrasound), device placement, confirmation of placement, and wound closure. This requires specialized training in breast imaging and interventional radiology or surgery.
In simple words: This procedure uses ultrasound to guide the placement of a tiny marker (like a clip or seed) into a breast lump to help surgeons find it during a biopsy.This is for the first lump found.
This CPT code, 19285, describes the percutaneous placement of a single breast localization device for the initial lesion identified.The procedure involves using ultrasound guidance to precisely locate the lesion within the breast tissue. A minimally invasive technique is employed to introduce the localization device (clip, metallic pellet, wire/needle, or radioactive seeds) through the skin to the target area.Post-placement, ultrasound is used to confirm the device's correct position. The procedure concludes with wound closure.This code is specifically for the initial lesion; additional devices or lesions necessitate additional codes.
Example 1: A 45-year-old female presents with a palpable breast mass detected during a routine mammogram.Ultrasound is performed, and a suspicious area is identified.Code 19285 is used for the placement of a localization wire to guide the subsequent biopsy., A 60-year-old female with a non-palpable breast lesion detected on mammogram.Ultrasound is used for localization. A radioactive seed is placed using 19285 to facilitate surgical excision., A 52-year-old woman undergoes a stereotactic core needle biopsy. The biopsy shows malignancy, and the surgeon decides to proceed with surgical lumpectomy.A localization wire is placed using 19285 to ensure accurate removal of the lesion during the lumpectomy.
* Pre-procedure imaging (mammogram or ultrasound) showing the lesion.* Documentation of the type of localization device used.* Intraoperative imaging (ultrasound) confirming placement of the device.* Anesthesia record.* Operative report clearly stating that a breast localization device was inserted.
** This code does not include the cost of the localization device itself. The device must be separately billed according to the supplier's billing procedures.
- Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
- RVU: This information is not provided and would require access to a specific payer's fee schedule.
- Global Days : Information on the global surgical period is not included in the provided data.This would depend on the specific payer's guidelines.
- Payment Status: Active
- Modifier TC rule: A Technical Component (TC) modifier may not be applicable, given that this is usually a single procedure performed by one provider. However, check payer-specific guidelines.
- Fee Schedule : Information not available. Consult a fee schedule database for historical data.
- Specialties:Radiology, Surgery, Breast Surgery
- Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center