CPT® Code 19288

Add-On Code

Placement of breast localization device(s) (eg clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including magnetic resonance guidance (List separately in addition to code for primary procedure)

The procedure described by CPT® Code 19288 involves the placement of breast localization device(s) to assist in accurately identifying the location of lesions within the breast prior to surgical interventions such as biopsies or lumpectomies. Localization devices can include various forms such as clips, metallic pellets, wires or needles, and radioactive seeds. This procedure is crucial for ensuring that the surgeon can precisely target the area of concern during the operation. 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 leverages the magnetic properties of hydrogen atoms present in the body, which emit radiofrequency signals when subjected to radio waves in a strong magnetic field. These signals are then processed by a computer to generate high-resolution, three-dimensional images of the breast tissue. During the procedure, specialized needles may be utilized, which can feature metallic ringlets, contrast material coatings, or signal-receiving coils at their tips to enhance imaging accuracy. The needle is carefully guided into the lesion using MRI, and additional imaging is performed to confirm the correct placement of the needle within the targeted mass. For wire localization, a hooked wire is inserted at a perpendicular angle to the lesion, remaining anchored in place as the needle is withdrawn, with a portion of the wire extending outside the skin. Alternatively, a localization device can be attached to a plastic stylet, which is inserted through the biopsy needle and advanced to the lesion site under MRI guidance. Once the localization device is positioned correctly, it is released, and both the stylet and needle are removed. It is important to note that CPT® Code 19288 is used for each additional lesion after the first, which is coded separately under 19287.