CPT® Code 19084

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

A percutaneous breast biopsy is a minimally invasive procedure that allows for the collection of tissue samples from breast lesions. This procedure is guided by ultrasound, which helps the physician accurately locate the lesion within the breast tissue. 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 use of ultrasound imaging is critical, as it provides real-time visualization of the lesion, allowing the radiologist to monitor the precise placement of the biopsy needle or device. 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 accurate diagnosis. Alternatively, if 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. 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, often obtaining between eight to ten samples to ensure a comprehensive evaluation of the lesion. To facilitate 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 surgeon, indicating the exact location of the tissue that has been biopsied. 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 removed. Additionally, imaging of the biopsy specimen may be performed to assist in the pathological examination of the collected tissue, ensuring that the samples are suitable for further analysis.