CPT® Code 19281

Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance

The procedure described by CPT® Code 19281 involves the placement of a breast localization device, which is essential for accurately identifying the location of a lesion prior to performing a breast biopsy or lumpectomy. This localization is crucial for ensuring that the surgeon can target the specific area of concern during the surgical procedure. The localization devices can include various types such as clips, metallic pellets, wires or needles, and radioactive seeds. The process begins with the marking of the lesion site on the skin, followed by obtaining mammographic images of the breast to visualize the lesion. Utilizing these images, a needle is carefully advanced into the lesion, and additional mammographic images are taken to confirm the precise placement of the needle within the mass. In cases where wire localization is employed, a hooked wire is inserted into the lesion at a perpendicular angle using a needle, ensuring that the wire remains anchored within the mass once the needle is withdrawn, with a portion of the wire extending out through the skin. Alternatively, a plastic stylet equipped with a localization device, such as a clip, metallic pellet, or radioactive seed, is inserted through the biopsy needle and guided to the lesion site using mammographic guidance. Once the localization device is positioned correctly, it is released, and both the stylet and needle are removed. This procedure is specifically coded as 19281 for the first lesion, while 19282 is used for each additional lesion that may require localization.