CPT® Code 19287

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

The procedure described by CPT® Code 19287 involves the placement of a breast localization device, which can include various types such as clips, metallic pellets, wires/needles, or radioactive seeds. This procedure is crucial for accurately identifying the location of a lesion in the breast prior to performing a biopsy or lumpectomy. The localization device serves as a marker, allowing the physician to precisely target the area of concern during surgical intervention. The use of magnetic resonance imaging (MRI) is integral to this process, as it provides a non-invasive and non-radiating method to visualize the internal structures of the breast. MRI operates by utilizing the magnetic properties of hydrogen atoms found in the body. When exposed to radio waves within a strong magnetic field, these hydrogen nuclei emit radiofrequency signals. A computer then processes these signals to generate high-resolution, three-dimensional images of the breast tissue. During the procedure, a specialized needle, which may feature metallic ringlets, contrast material, or a signal-receiving coil, is guided into the lesion under MRI guidance. This ensures accurate placement of the localization device. For wire localization, a hooked wire is inserted at a perpendicular angle to the lesion, remaining anchored within the mass once the needle is withdrawn, with a portion of the wire extending outside the skin. Alternatively, a plastic stylet with a localization device is advanced to the lesion site, where it is released before the stylet and needle are removed. This procedure is specifically coded as 19287 for the first lesion, while 19288 is used for each additional lesion that may require localization.