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2025 CPT code 19286

Percutaneous placement of each additional breast localization device (e.g., clip, pellet, wire, seed) using ultrasound guidance; add-on code.

Refer to the CPT guidelines for surgical procedures on the integumentary system and for the use of add-on codes.Pay close attention to the rules concerning the use of additional localization device placement codes when different imaging modalities are used.

Modifiers may be applicable depending on the circumstances of the procedure.Consult the CPT modifier guidelines for appropriate use.

The placement of breast localization devices is medically necessary to facilitate accurate localization of lesions prior to biopsy or surgical excision.This improves the accuracy of the procedure and reduces the need for repeat procedures.

The physician is responsible for performing the ultrasound-guided percutaneous placement of the additional localization device.This includes prepping the patient, administering anesthesia (if necessary), using ultrasound to locate the target lesion, inserting the device, verifying placement, and closing the puncture site.

IMPORTANT:This is an add-on code; it requires a primary code such as 19285.Other codes (19281-19288) exist for placement of localization devices using different imaging modalities (mammography or stereotactic guidance).

In simple words: This code is for placing extra small markers in the breast to pinpoint a problem area before a biopsy.The doctor uses ultrasound to guide the placement of these markers, and this code is only used if the doctor already placed another marker in the breast during the same visit.

This CPT code, 19286, reports the percutaneous placement of each additional breast localization device (e.g., clip, metallic pellet, wire/needle, radioactive seeds) under ultrasound guidance.This is an add-on code and must be reported in addition to a primary procedure code (19285 for the initial lesion using ultrasound guidance).The procedure involves using ultrasound imaging to guide the placement of the device into the target tissue via a minimally invasive approach. The code is used when more than one localization device is placed in the same session, either on the same or contralateral breast, using the same imaging modality (ultrasound).

Example 1: A patient presents with a palpable breast mass.The physician performs ultrasound-guided placement of a localization wire at the initial lesion (19285).During the same session, the physician identifies an additional suspicious area and places another localization wire (19286). , A patient undergoes a mammogram revealing two suspicious lesions in the same breast.The physician utilizes ultrasound to place a localization clip in the first lesion (19285) and then another clip in the second lesion (19286)., A patient has a palpable mass in one breast and a suspicious area on the mammogram of the contralateral breast.The physician places a localization device in the first breast (19285) and then places a second device in the contralateral breast (19286).

* Pre-procedure images (mammogram, ultrasound) showing the lesion(s)* Operative report detailing the placement of each device, including location and type of device used.* Post-procedure images verifying the placement of each device.* Anesthesia record, if applicable

** Ensure that the documentation clearly specifies the number of additional lesions and the imaging modality used. The description should be detailed enough to ensure accurate reimbursement.Payers may have specific requirements, so review payer-specific guidelines.

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