CPT® Code 19291

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1. Indications

The procedure associated with CPT® Code 19291 is indicated for patients who have multiple breast lesions that require surgical intervention. The following conditions may warrant the use of this procedure:

• Multiple Lesions Patients with more than one identified breast mass that necessitates localization for surgical excision.
• Preoperative Planning Situations where precise localization of lesions is critical for effective surgical planning and execution.
• Imaging Findings Cases where imaging studies, such as mammograms or ultrasounds, reveal additional lesions that need to be addressed during surgery.

2. Procedure

The procedure for CPT® Code 19291 involves several key steps that ensure accurate placement of the localization wire for each additional lesion. The following outlines the procedural steps:

• Step 1: Patient Preparation The patient is positioned appropriately, and the area of the breast is cleaned and sterilized to minimize the risk of infection. The physician reviews the imaging studies to identify the location of the additional lesions that require localization.
• Step 2: Imaging Guidance Utilizing imaging guidance, such as ultrasound or mammography, the physician locates the targeted mass. This step is crucial as it ensures that the needle is accurately placed over the lesion, allowing for precise intervention.
• Step 3: Needle Insertion A hollow needle is carefully inserted through the skin of the breast, directly over the identified lesion. The physician ensures that the needle is positioned correctly to facilitate the next step.
• Step 4: Guidewire Placement Once the needle is in place, a guidewire is threaded through the hollow needle and into the mass. This guidewire serves as a marker for the surgeon, indicating the exact location of the lesion during the surgical procedure.
• Step 5: Confirmation After the guidewire is placed, the physician may perform additional imaging to confirm that the wire is correctly positioned within the lesion. This step is essential to ensure that the localization is accurate before proceeding with surgery.

3. Post-Procedure

After the placement of the localization wire using CPT® Code 19291, the patient may be monitored for any immediate complications, such as bleeding or infection at the insertion site. The localization wire remains in place until the surgical procedure is performed, allowing the surgeon to accurately locate the lesion. Patients are typically advised on post-procedure care, which may include instructions to avoid strenuous activities and to keep the area clean and dry. Follow-up appointments may be scheduled to ensure proper healing and to discuss the results of the surgical intervention.