CPT® Code 19081

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 stereotactic guidance

A percutaneous breast biopsy is a minimally invasive procedure that allows for the sampling of breast tissue to diagnose potential abnormalities. This procedure is guided by stereotactic imaging, which employs a fixed coordinate system to accurately locate the lesion within the breast. The process begins with the cleansing of the skin and the administration of a local anesthetic to ensure patient comfort. Stereotactic guidance involves the use of imaging technology to pinpoint the lesion's precise location by defining it in three-dimensional coordinates relative to a reference point. During the procedure, the breast is positioned between a compression plate and a support structure, which stabilizes the lesion for accurate targeting. The thickness of the breast under compression is a critical factor in determining the depth of the lesion. An initial imaging study is performed at a perpendicular angle to the compression plate, which helps to center the lesion within the biopsy window. Subsequent images are taken at various angles to further refine the location of the lesion through geometric calculations. If a needle biopsy is indicated, a needle is carefully inserted into the lesion to obtain a tissue sample. Typically, multiple core needle insertions—ranging from three to six—are necessary to ensure that an adequate sample is collected for analysis. Once the tissue sample is secured, it is sent to a laboratory for pathological examination. In cases where an automated vacuum-assisted or rotating biopsy device is utilized, the procedure involves making a small incision in the skin and placing a breast probe at the lesion site. The device then uses suction to draw tissue into its sampling chamber, or a rotating cutting mechanism is employed to capture tissue samples. This process may involve taking between eight to ten samples, with the probe being repositioned at approximately 30-degree intervals. After the sampling is completed, pressure is applied to the biopsy site to minimize bleeding. Additionally, a metallic localization clip or pellet may be placed at the biopsy site to assist in future surgical procedures, such as a lumpectomy, by marking the exact location of the tissue removal. The procedure concludes with the removal of the biopsy needle and the potential acquisition of additional images of the biopsy specimen for further evaluation.