How To Use CPT Code 19285

CPT 19285 refers to the percutaneous placement of a breast localization device using ultrasound guidance for the first lesion. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 19285.

1. What is CPT 19285?

CPT 19285 is a medical procedure code used to describe the percutaneous placement of a breast localization device, such as a clip, metallic pellet, wire/needle, or radioactive seeds, using ultrasound guidance for the first lesion. This procedure is typically performed prior to a breast biopsy to accurately locate the site of the lesion.

2. 19285 CPT code description

The official description of CPT code 19285 is: “Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance.”

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The provider uses ultrasound guidance to view the exact location of the lesion in the breast.
3. The provider uses a needle or other minimally invasive introducer instrument to place the localization device through the skin at the target tissue.
4. After placement of the device, the provider uses ultrasound guidance to ensure the correct position of the device.
5. The site is closed with a bandage.

4. Qualifying circumstances

Patients eligible to receive CPT code 19285 services are those with a suspicious breast lesion that requires localization prior to a breast biopsy. The lesion may be identified through mammography, ultrasound, or other imaging studies. The patient’s medical history, physical examination, and imaging findings should support the need for the procedure.

5. When to use CPT code 19285

It is appropriate to bill the 19285 CPT code when a provider performs the percutaneous placement of a breast localization device using ultrasound guidance for the first lesion. This code should be used when the procedure is performed independently and not in conjunction with a breast biopsy. If a breast biopsy is performed along with the localization device placement, use CPT codes 19081 to 19086 instead.

6. Documentation requirements

To support a claim for CPT 19285, the following information should be documented in the patient’s medical record:

• Indication for the procedure, including the presence of a suspicious breast lesion requiring localization.
• Details of the ultrasound guidance used during the procedure.
• Specific type of localization device used (e.g., clip, metallic pellet, wire/needle, radioactive seeds).
• Step-by-step description of the procedure, including the placement and confirmation of the device’s position.
• Any complications or adverse events encountered during the procedure.

7. Billing guidelines

When billing for CPT code 19285, it is important to follow the appropriate guidelines and rules. Use +19286 for placement of each additional device. Breast localization device placement codes 19281 to +19288 vary based on the type of guidance the provider uses. If a breast biopsy is performed along with the localization device placement, use CPT codes 19081 to 19086 instead.

8. Historical information

CPT 19285 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 19285

Five similar codes to CPT 19285 differentiate based on the type of guidance used and the number of lesions:

• CPT 19281: Placement of breast localization device using stereotactic guidance for the first lesion.
• CPT 19283: Placement of breast localization device using magnetic resonance guidance for the first lesion.
• +19284: Placement of breast localization device using stereotactic guidance for each additional lesion.
• +19286: Placement of breast localization device using ultrasound guidance for each additional lesion.
• +19288: Placement of breast localization device using magnetic resonance guidance for each additional lesion.

10. Examples

1. A 45-year-old female with a suspicious breast lesion identified on mammography undergoes percutaneous placement of a clip using ultrasound guidance for localization prior to biopsy.
2. A 55-year-old female with a history of breast cancer presents with a new suspicious lesion on ultrasound, and a metallic pellet is placed percutaneously using ultrasound guidance for localization.
3. A 50-year-old female with a palpable breast mass undergoes percutaneous placement of a wire/needle using ultrasound guidance for localization prior to surgical excision.
4. A 60-year-old female with a suspicious breast lesion identified on MRI undergoes percutaneous placement of radioactive seeds using ultrasound guidance for localization prior to lumpectomy.
5. A 40-year-old female with a high-risk lesion identified on breast ultrasound undergoes percutaneous placement of a clip using ultrasound guidance for localization prior to vacuum-assisted biopsy.
6. A 65-year-old female with a suspicious breast lesion identified on mammography undergoes percutaneous placement of a metallic pellet using ultrasound guidance for localization prior to core needle biopsy.
7. A 48-year-old female with a suspicious breast lesion identified on ultrasound undergoes percutaneous placement of a wire/needle using ultrasound guidance for localization prior to excisional biopsy.
8. A 52-year-old female with a suspicious breast lesion identified on MRI undergoes percutaneous placement of radioactive seeds using ultrasound guidance for localization prior to radiation therapy.
9. A 57-year-old female with a suspicious breast lesion identified on mammography undergoes percutaneous placement of a clip using ultrasound guidance for localization prior to cryoablation.
10. A 62-year-old female with a suspicious breast lesion identified on ultrasound undergoes percutaneous placement of a metallic pellet using ultrasound guidance for localization prior to radiofrequency ablation.