How To Use CPT Code 19084

CPT code 19084 describes the percutaneous biopsy of each additional breast lesion, including the placement of a breast localization device and imaging of the biopsy specimen, when performed. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 19084?

CPT 19084 is used to describe the percutaneous biopsy of each additional breast lesion, including the placement of a breast localization device and imaging of the biopsy specimen, when performed. This code is an add-on code that is reported in addition to the primary procedure code 19083. It is used when the provider takes breast tissue percutaneously for biopsy from each additional lesion after the first separately reportable lesion.

2. Official Description

The official description of CPT code 19084 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 each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)’

3. Procedure

During the same session as a separately reportable biopsy of an initial breast lesion, the provider makes a small incision and removes tissue from an additional breast lesion. The procedure is performed percutaneously, meaning that the tissue is obtained through the skin. The provider may also place one or more breast localization devices, such as clips or metallic pellets, at the same time. Imaging of the biopsy specimen may also be performed. The entire procedure is performed under ultrasound guidance to ensure accuracy and precision.

4. Qualifying circumstances

CPT 19084 is used when the provider performs a percutaneous biopsy of each additional breast lesion after the first separately reportable lesion. The procedure is typically performed when there are multiple suspicious or concerning lesions identified in the breast that require further evaluation. The provider must use ultrasound guidance to accurately target and obtain tissue samples from each additional lesion. The placement of breast localization devices and imaging of the biopsy specimen are optional but included if performed.

5. When to use CPT code 19084

CPT code 19084 should be used when the provider performs a percutaneous biopsy of each additional breast lesion, including the placement of breast localization devices and imaging of the biopsy specimen, when performed. This code is reported in addition to the primary procedure code 19083. It should not be reported if only one breast lesion is biopsied.

6. Documentation requirements

To support a claim for CPT code 19084, the provider must document the following information:

• Number of additional breast lesions biopsied
• Specific breast localization devices placed, if applicable
• Imaging of the biopsy specimen, if performed
• Date and start time of the procedure
• Ultrasound guidance used during the procedure
• Incision site and closure method
• Any complications or adverse events
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 19084, ensure that the provider has already performed a separately reportable biopsy of an initial breast lesion using code 19083. CPT code 19084 is an add-on code that should be reported once for each additional breast lesion biopsied. It is important to include the appropriate modifiers and follow any specific billing guidelines provided by the payer. Localization device placement and specimen imaging are not required for this code, but they are included if performed.

8. Historical information

CPT code 19084 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 19084

Five similar codes to CPT 19084 include:

• CPT 19083: This code is used for the biopsy of an initial breast lesion, including imaging guidance.
• CPT 19085: This code is used for the biopsy of an initial breast lesion, including placement of a breast localization device and imaging of the biopsy specimen, when performed.
• CPT 19086: This code is used for the biopsy of an initial breast lesion, including placement of a breast localization device and imaging of the biopsy specimen, when performed, with percutaneous needle core biopsy of the breast.
• CPT 19100: This code is used for the biopsy of the breast, percutaneous, needle core, not using imaging guidance.
• CPT 19101: This code is used for the biopsy of the breast, open, incisional.

9. Examples

1. A radiologist performing a percutaneous biopsy of an additional breast lesion using ultrasound guidance, placing a breast localization device, and imaging the biopsy specimen.
2. A surgeon performing a percutaneous biopsy of multiple suspicious breast lesions, using ultrasound guidance and placing breast localization devices, but not imaging the biopsy specimen.
3. An interventional radiologist performing a percutaneous biopsy of each additional breast lesion after an initial biopsy, using ultrasound guidance and imaging the biopsy specimen.
4. A breast surgeon performing a percutaneous biopsy of multiple breast lesions, using ultrasound guidance and placing breast localization devices, but not imaging the biopsy specimen.
5. A radiologist performing a percutaneous biopsy of each additional breast lesion, using ultrasound guidance and imaging the biopsy specimen, but not placing breast localization devices.