How To Use CPT Code 19281

CPT code 19281 describes the placement of a breast localization device under mammographic guidance for the first lesion. 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 19281?

CPT 19281 is used to describe the placement of a breast localization device under mammographic guidance for the first lesion. This code is used when a provider uses mammography to view the exact location of the lesion in the breast and places a device, such as a clip, metallic pellet, wire, needle, or radioactive seeds, to mark the target tissue.

2. Official Description

The official description of CPT code 19281 is: ‘Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous first lesion, including mammographic guidance.’

3. Procedure

In this procedure, the provider begins by using mammography to view the exact location of the lesion in the breast. They take several images to accurately identify the site of the lesion. The provider then uses a needle or other minimally invasive introducer instrument to place the breast localization device through the skin at the target tissue. After placing the device, the provider takes another mammogram to ensure correct positioning and closes the site with a bandage. The goal of the procedure is to locate and identify the site of the lesion prior to breast biopsy.

4. Qualifying circumstances

CPT 19281 is performed on patients who require localization of a breast lesion for further evaluation or biopsy. The procedure is typically performed under mammographic guidance and involves the placement of a device to mark the location of the lesion. This code is used for the first lesion and may be performed in conjunction with other breast biopsy procedures.

5. When to use CPT code 19281

CPT code 19281 should be used when a provider performs the placement of a breast localization device under mammographic guidance for the first lesion. It is important to note that this code is specific to the percutaneous placement of the device and should not be used for open incisional biopsies or subsequent placements of additional devices.

6. Documentation requirements

To support a claim for CPT 19281, the provider must document the following information:

• Patient’s diagnosis and the need for breast lesion localization
• Type of breast localization device used
• Date of the procedure
• Start and end time of the procedure
• Details of the mammographic guidance used
• Confirmation of correct device placement through post-procedure mammogram
• Any additional relevant information or findings

7. Billing guidelines

When billing for CPT 19281, ensure that the procedure involves the placement of a breast localization device under mammographic guidance for the first lesion. This code should not be reported if the provider performs an open incisional biopsy after the placement of the device. If additional devices are placed using the same imaging modality, use the add-on code +19282. If different imaging modalities are used for additional placements, report another primary code for each additional modality.

8. Historical information

CPT 19281 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 19281

Five similar codes to CPT 19281 include:

• CPT 19282: This add-on code is used for each additional breast localization device placed using the same imaging modality.
• CPT 19081: This code is used for breast biopsy, percutaneous, with placement of breast localization device(s) using imaging guidance, first lesion.
• CPT 19082: This code is used for breast biopsy, percutaneous, with placement of breast localization device(s) using imaging guidance, each additional lesion.
• CPT 19101: This code is used for open incisional biopsy of the breast.
• CPT 19288: This add-on code is used for each additional breast localization device placed using a different imaging modality.

9. Examples

1. A radiologist placing a metallic pellet under mammographic guidance to mark the location of a suspicious breast lesion for further evaluation.
2. A surgeon using mammography to guide the placement of a wire to localize a non-palpable breast lesion prior to surgical excision.
3. An interventional radiologist placing a clip under mammographic guidance to mark the site of a breast lesion for future reference during follow-up imaging.
4. A breast imaging specialist using mammography to guide the placement of radioactive seeds to mark the location of a breast lesion for targeted radiation therapy.
5. A nurse practitioner assisting a radiologist in placing a needle under mammographic guidance to mark the location of a suspicious breast lesion for biopsy.
6. A breast surgeon using mammography to guide the placement of a metallic clip to mark the site of a breast lesion prior to neoadjuvant chemotherapy.
7. An oncologist placing a wire under mammographic guidance to localize a non-palpable breast lesion for preoperative planning.
8. A radiology technician assisting a radiologist in placing a needle under mammographic guidance to mark the location of a breast lesion for subsequent biopsy.
9. A breast surgeon using mammography to guide the placement of a metallic pellet to mark the site of a breast lesion for future reference during surveillance imaging.
10. An interventional radiologist placing a wire under mammographic guidance to localize a non-palpable breast lesion for preoperative localization and surgical excision.