There were separate codes for breast biopsy procedures along with guidance. We have to assign multiple codes for breast procedures earlier. However, from 2014 we have bundled CPT codes of breast biopsy with guidance. New breast biopsy CPT codes helps in coding the Interventional radiology procedures easily.  We have individual code for breast biopsy with guidance. Lets checkout the new breast biopsy cpt codes.

New Breast biopsy CPT Codes in IVR

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Breast Biopsy CPT Codes  with Stereotactic Guidance

Before, we used to code Breast biopsy code separately with stereotactic guidance CPT Code. However,  from 2014 we have been provided with bundled CPT code including stereotactic guidance. We have two codes for breast biopsy with stereotactic guidance, 19081 and 19082. Now, when the breast biopsy is done on the first lesion with the help of stereotactic guidance we use 19081. Cpt Code 19082 is an add-on code. It should be always used with 19081. Breast biopsy done for each additional lesion, CPT code 19082 is used.

19081     Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including stereotactic guidance
+19082     for each additional lesion

New breast biopsy CPT Codes with ultrasound guidance

Here we have the same thing to follow, the only difference is about the ultrasound guidance. Here also we have two CPT codes for first lesion and for each additional lesion. The cpt codes used for the ultrasound guided breast biopsy are 19083 and 19084. The breast biopsy performed with ultrasound guidance for first lesion is coded with 19083. For each additional lesion add-on code is used 19084. 19084 is never used primary and should be always used with 19083.

19083 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including ultrasound guidance
+19084 for each additional lesion

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New breast biopsy CPT Codes  with Magnetic Resonance (MR)

MR guided breast biopsy procedure also have two CPT codes.  Here, also we will have a primary CPT code for first lesion and an add-on code for each secondary lesion. The cpt code used for MR guided breast biopsy procedures are 19085 and 19086. 19085 is used as primary code for first lesion with 19086 for each addition lesion.

19085 Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance

+19086 for each additional lesion

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New CPT Codes for Localization Device Placement in Breast

New breast biopsy CPT Codes for 2014 with CT guidance

CT guided breast biopsy have separate codes earlier for breast biopsy and CT guidance. However, in 2014 they have deleted only the main breast biopsy procedure. Here, we have slight difference in primary CPT code. We will have two codes here because we do not have any bundled CPT code for CT guided breast biopsy like others. In 2014, we are using an unlisted CPT code for breast procedure 19499 as primary code for CT guided breast biopsy. We will also code the CT guidance code 77012 along with 19499. Hence, we will code an unlisted CPT code for CT guided breast biopsy for first lesion.

19499 Unlisted breast procedure
77012 CT guidance used for Biopsy

For each addition lesion studied, we can code again the unlisted 19499 CPT code with 59 modifier.

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Coding for Post biopsy Mammogram 

Postbiopsy mammograms are performed to verify the clip deployment. Clip is placed 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. Postbiopsy mammogram are included in breast biopsy and metallic localization clip placement procedures. 

If a breast biopsy, needle localization wire, metallic localization clip, or other breast procedure is performed with mammographic guidance, then the physician should not separately report a post procedure mammography code (eg, 77065-77067, G0202 to G0206) for the same patient encounter. The radiologic guidance codes include all imaging by the defined modality required to perform the procedure.

For stereotactic procedures, the postprocedure mammogram should only be reported only if the patient is moved to a dedicated mammography unit. If the postprocedure exam is performed on the stereotactic table, it is not separately reportable. When a mammograms is performed following a mammographically guided procedure, the mammogram is always considered to be included in the mammographic guidance and should not be coded separately.

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CPT codes for breast localization device placement

Their is separate list of Beast localization device like metallic pellet or clip placement. These procedures codes are also bundled and include the guidance codes and post mammogram procedures. Below is a detail code description of these CPT codes.

19283 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including stereotactic guidance

+19284 …each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)

19285 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance

+19286 …each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)

19287 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including magnetic resonance guidance

+19288 …each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure)

Hope you can get more information about new breast biopsy CPT Codes through this article. If you like the article do share it.