CPT® Code 19083

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 ultrasound guidance

A percutaneous breast biopsy is a minimally invasive procedure that allows for the collection of tissue samples from a breast lesion. This procedure is guided by ultrasound, which provides real-time imaging to assist the physician in accurately locating the lesion. Initially, the skin over the biopsy site is cleansed to reduce the risk of infection, and a local anesthetic is administered to ensure patient comfort during the procedure. The ultrasound transducer is then employed to visualize the lesion, allowing the radiologist to monitor the precise placement of the biopsy needle or device throughout the process. During the biopsy, if a needle biopsy is performed, the physician inserts a specialized needle into the lesion to extract a tissue sample. Typically, multiple core needle insertions—ranging from three to six—are necessary to obtain sufficient tissue for diagnostic purposes. Alternatively, if an automated vacuum-assisted or rotating biopsy device is utilized, the procedure begins with a small incision in the skin, followed by the placement of a breast probe at the lesion site. This device uses a vacuum mechanism to draw breast tissue into its sampling chamber, or a rotating cutting mechanism to capture tissue samples. The physician may rotate the probe approximately 30 degrees between samples, allowing for the collection of 8 to 10 samples in total. To enhance the accuracy of future surgical procedures, such as a lumpectomy, a metallic localization clip or pellet may be placed at the biopsy site. This clip serves as a marker for the physician to identify the exact location of the tissue that has been removed. After the biopsy is completed, the needle is typically left in place while a plastic stylet with a metal clip or pellet is inserted through the needle and guided to the biopsy site using ultrasound. Once positioned, the clip or pellet is released, and both the stylet and needle are withdrawn. Additionally, imaging of the biopsy specimen may be performed to ensure the adequacy of the sample before it is sent for pathological examination. The CPT® code 19083 is designated for the biopsy of the first lesion, while 19084 is used for each additional lesion biopsied.