CPT® Code 19082

Add-On Code

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 stereotactic guidance (List separately in addition to code for primary procedure)

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 minimize discomfort. The stereotactic technique involves positioning the breast between a compression plate and a support structure, which stabilizes the lesion for precise targeting. The breast's thickness 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 triangulate the lesion's position in three-dimensional space. When the biopsy needle is inserted into the lesion, multiple core needle insertions—typically between three to six—are performed to ensure an adequate tissue sample is collected. The obtained samples are then sent to a laboratory for pathological analysis. In cases where an automated vacuum-assisted or rotating biopsy device is utilized, the procedure involves nicking the skin and placing a probe at the lesion site. This device uses a vacuum to draw tissue into a sampling chamber, or a rotating cutting mechanism to capture tissue samples, with multiple samples taken in succession. Additionally, if a more extensive surgical procedure, such as a lumpectomy, is anticipated, a metallic localization clip or pellet is placed at the biopsy site to mark the exact location of the tissue removal. This is accomplished by leaving the biopsy needle in place while a plastic stylet with the clip or pellet is inserted and positioned using imaging guidance. After the clip or pellet is deployed, the needle and stylet are removed. Finally, additional imaging of the biopsy specimen may be performed before the tissue is sent for separate pathological examination. The coding for this procedure includes CPT® Code 19081 for the biopsy of the first lesion and CPT® Code 19082 for each additional lesion biopsied.