How To Use CPT Code 19085

CPT 19085 describes the percutaneous biopsy of breast tissue from a single lesion, with the placement of breast localization device(s) and imaging of the biopsy specimen, under magnetic resonance guidance. 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 19085?

CPT 19085 is used to describe the percutaneous biopsy of breast tissue from a single lesion, with the placement of breast localization device(s) and imaging of the biopsy specimen, under magnetic resonance guidance. This code is specifically for the first lesion biopsied and includes the use of magnetic resonance (MR) guidance.

2. Official Description

The official description of CPT code 19085 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 magnetic resonance guidance.’

3. Procedure

Under magnetic resonance guidance, the healthcare provider makes a small incision and removes breast tissue from a single lesion for biopsy. During the procedure, the provider may also place one or more breast localization devices and image the biopsy specimen. After removing the tissue, the provider applies pressure and bandages at the incision site. It is important to note that the use of magnetic resonance guidance is a key component of this procedure.

4. Qualifying circumstances

CPT 19085 is used when a percutaneous biopsy of breast tissue is performed from a single lesion, with the placement of breast localization device(s) and imaging of the biopsy specimen, under magnetic resonance guidance. The procedure is typically performed for diagnostic purposes when there is suspicion of breast cancer or other abnormalities in the breast tissue.

5. When to use CPT code 19085

CPT code 19085 should be used when a healthcare provider performs a percutaneous biopsy of breast tissue from a single lesion, with the placement of breast localization device(s) and imaging of the biopsy specimen, under magnetic resonance guidance. It is important to note that this code is specifically for the first lesion biopsied and includes the use of magnetic resonance guidance.

6. Documentation requirements

To support a claim for CPT 19085, the healthcare provider must document the following information:

• Indication for the biopsy and the specific lesion being biopsied
• Use of magnetic resonance guidance during the procedure
• Placement of breast localization device(s), if performed
• Imaging of the biopsy specimen, if performed
• Date, start and end time of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 19085, ensure that the procedure includes the percutaneous biopsy of breast tissue from a single lesion, placement of breast localization device(s), and imaging of the biopsy specimen, all performed under magnetic resonance guidance. It is important to note that this code is specifically for the first lesion biopsied. If additional lesions are biopsied under magnetic resonance guidance, use CPT code 19086 for each additional lesion.

8. Historical information

CPT 19085 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 19085

Five similar codes to CPT 19085 include:

• CPT 19086: This code is used for each additional lesion biopsied from the breast under magnetic resonance guidance.
• CPT 19081: This code is used for the percutaneous biopsy of breast tissue without the placement of breast localization device(s) or imaging of the biopsy specimen.
• CPT 19082: This code is used for the percutaneous biopsy of breast tissue with the placement of breast localization device(s), but without imaging of the biopsy specimen.
• CPT 19083: This code is used for the percutaneous biopsy of breast tissue with imaging of the biopsy specimen, but without the placement of breast localization device(s).
• CPT 19084: This code is used for the percutaneous biopsy of breast tissue with the placement of breast localization device(s) and imaging of the biopsy specimen, but without magnetic resonance guidance.

9. Examples

1. A radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
2. A breast surgeon performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of multiple breast localization pellets and imaging of the biopsy specimen, under magnetic resonance guidance.
3. An interventional radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
4. A breast radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
5. A breast surgeon performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
6. An interventional radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of multiple breast localization pellets and imaging of the biopsy specimen, under magnetic resonance guidance.
7. A radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
8. A breast surgeon performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of multiple breast localization pellets and imaging of the biopsy specimen, under magnetic resonance guidance.
9. An interventional radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.
10. A breast radiologist performing a percutaneous biopsy of breast tissue from a single lesion, with the placement of a breast localization clip and imaging of the biopsy specimen, under magnetic resonance guidance.