How To Use CPT Code 19083

CPT 19083 refers to a percutaneous breast biopsy procedure with the possible placement of a breast localization device and imaging of the biopsy specimen, performed under ultrasound guidance. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 19083 procedures.

1. What is CPT 19083?

CPT 19083 is a medical code used to describe a percutaneous breast biopsy procedure that may involve the placement of a breast localization device and imaging of the biopsy specimen. This procedure is performed under ultrasound guidance and is used to diagnose and treat breast abnormalities, such as suspicious masses or calcifications.

2. 19083 CPT code description

The official description of CPT code 19083 is: “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 ultrasound guidance.”

3. Procedure

1. The patient is positioned comfortably, and the skin over the breast lesion is cleaned and sterilized.
2. Local anesthesia is administered to numb the area.
3. Under ultrasound guidance, the provider inserts a needle or biopsy device through the skin and into the breast lesion.
4. Tissue samples are collected from the lesion for further examination.
5. If necessary, a breast localization device (e.g., clip, metallic pellet) is placed at the biopsy site.
6. Imaging of the biopsy specimen may be performed, if required.
7. The needle or biopsy device is removed, and pressure is applied to the incision site to minimize bleeding.
8. A bandage is applied to the incision site.

4. Qualifying circumstances

Patients eligible to receive CPT code 19083 services are those with suspicious breast abnormalities detected through physical examination, mammography, or other imaging studies. These abnormalities may include masses, calcifications, or architectural distortions. The procedure is typically performed when a less invasive diagnostic method, such as a fine needle aspiration, is not sufficient or when a more accurate diagnosis is needed to guide treatment decisions.

5. When to use CPT code 19083

It is appropriate to bill the 19083 CPT code when a percutaneous breast biopsy is performed under ultrasound guidance, with or without the placement of a breast localization device and imaging of the biopsy specimen. This code should be used for the first lesion biopsied during the procedure. If additional lesions are biopsied, the add-on code +19084 should be used for each subsequent lesion.

6. Documentation requirements

To support a claim for CPT 19083, the following information should be documented in the patient’s medical record:

• Indication for the procedure, such as the presence of a suspicious breast abnormality.
• Details of the ultrasound-guided percutaneous breast biopsy procedure, including the type of biopsy device used and the number of tissue samples obtained.
• Whether a breast localization device was placed and, if so, the type of device used.
• Whether imaging of the biopsy specimen was performed and the results of the imaging.
• Post-procedure care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 19083, it is important to follow the appropriate guidelines and rules. This code includes ultrasound guidance and applies to the first lesion biopsied. If additional lesions are biopsied during the same procedure, the add-on code +19084 should be used for each subsequent lesion. The placement of a breast localization device and imaging of the biopsy specimen are not required for this code, but they are included if performed.

8. Historical information

CPT 19083 was added to the Current Procedural Terminology system on January 1, 2014. There have been no updates to the code since its addition.

9. Similar codes to CPT 19083

Five similar codes to CPT 19083 and how they differ are:

1. CPT 19081: This code describes a percutaneous breast biopsy performed under stereotactic guidance, without ultrasound guidance.
2. CPT 19082: This code is used for each additional lesion biopsied under stereotactic guidance during the same procedure.
3. CPT 19084: This add-on code is used for each additional lesion biopsied under ultrasound guidance during the same procedure as CPT 19083.
4. CPT 19085: This code describes a percutaneous breast biopsy performed under magnetic resonance (MR) guidance, without ultrasound guidance.
5. CPT 19086: This code is used for each additional lesion biopsied under MR guidance during the same procedure.

10. Examples

1. A patient with a palpable breast mass undergoes an ultrasound-guided percutaneous breast biopsy with placement of a metallic clip at the biopsy site.
2. A patient with a suspicious breast calcification detected on mammography undergoes an ultrasound-guided percutaneous breast biopsy without placement of a localization device.
3. A patient with a breast mass detected on ultrasound undergoes an ultrasound-guided percutaneous breast biopsy with imaging of the biopsy specimen.
4. A patient with a history of breast cancer presents with a new breast mass and undergoes an ultrasound-guided percutaneous breast biopsy with placement of a metallic pellet at the biopsy site.
5. A patient with a complex breast cyst undergoes an ultrasound-guided percutaneous breast biopsy without placement of a localization device or imaging of the biopsy specimen.
6. A patient with a suspicious breast mass detected on MRI undergoes an ultrasound-guided percutaneous breast biopsy with placement of a clip at the biopsy site and imaging of the biopsy specimen.
7. A patient with a breast mass detected on mammography undergoes an ultrasound-guided percutaneous breast biopsy with placement of a metallic clip and imaging of the biopsy specimen.
8. A patient with a breast mass detected on ultrasound undergoes an ultrasound-guided percutaneous breast biopsy with placement of a metallic pellet and imaging of the biopsy specimen.
9. A patient with a suspicious breast mass detected on physical examination undergoes an ultrasound-guided percutaneous breast biopsy without placement of a localization device or imaging of the biopsy specimen.
10. A patient with a history of breast cancer presents with a new breast mass and undergoes an ultrasound-guided percutaneous breast biopsy with placement of a metallic clip at the biopsy site and imaging of the biopsy specimen.