CPT® Code 19285

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

The procedure described by CPT® Code 19285 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 targets the correct area during the surgical procedure. The devices used for localization can include clips, metallic pellets, wires or needles, and radioactive seeds. The process begins with the marking of the area of concern on the skin, followed by the acquisition of ultrasound images of the breast to visualize the lesion. A transducer is employed to precisely locate the lesion, and the physician uses these images to guide the insertion of a needle into the lesion. Throughout this process, the radiologist continuously monitors the placement of the needle to confirm that it is correctly positioned within the mass. For wire localization, a hooked wire is inserted at a perpendicular angle to the lesion using a needle, ensuring that the wire remains anchored within the mass once the needle is withdrawn, with a portion of the wire extending outside the skin.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 advanced to the lesion site under ultrasound guidance. Once the localization device is in place, it is released, and both the stylet and needle are removed. This procedure is specifically coded as 19285 for the first lesion, while 19286 is used for each additional lesion that may require localization.