CPT® Code 19086

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 magnetic resonance 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 using magnetic resonance imaging (MRI) guidance. This technique utilizes the magnetic properties of hydrogen atoms within the body, which emit radiofrequency signals when exposed to radio waves in a strong magnetic field. The MRI system processes these signals to create high-resolution, three-dimensional images of the breast tissue, enabling precise localization of the lesion. During the procedure, the skin over the target area is cleansed, and local anesthesia is administered to minimize discomfort. A specialized biopsy needle, which may be equipped with metallic ringlets, contrast material, or a signal-receiving coil, is then inserted into the lesion under MRI guidance. To ensure an adequate tissue sample, multiple core needle insertions—typically between three to six—are performed. If an automated vacuum-assisted or rotating biopsy device is utilized, a small incision is made, and a breast probe is inserted to draw tissue into the sampling chamber. This device can take multiple samples, often ranging from eight to ten, by rotating approximately 30 degrees between each sample. After the tissue collection is complete, 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 mark the location for future surgical procedures, such as a lumpectomy. This procedure may also include imaging of the biopsy specimen to ensure proper documentation and facilitate subsequent pathological examination of the collected tissue.