© Copyright 2025 American Medical Association. All rights reserved.
The CPT® Code 19286 refers to the procedure of placing breast localization devices, which are essential tools used to mark the precise location of a lesion in the breast prior to surgical interventions such as a biopsy or lumpectomy. These localization devices can include various forms such as clips, metallic pellets, wires or needles, and radioactive seeds. The primary purpose of this procedure is to ensure that the physician can accurately identify the lesion site during surgery. The process begins with the marking of the area of concern on the skin, followed by the acquisition of ultrasound images of the breast. A transducer is employed to locate the lesion, and the physician uses these images to guide a needle into the lesion. Throughout this process, the radiologist continuously monitors the needle's placement to confirm 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wire is inserted at a perpendicular angle to the lesion using a needle, remaining anchored in place when the needle is withdrawn, with a portion of the wire extending outside the skin. Alternatively, a plastic stylet equipped with a localization device is inserted through the biopsy needle and advanced to the lesion site under ultrasonic guidance, where the localization device is released before the removal of the stylet and needle. It is important to note that CPT® Code 19286 is specifically used for each additional lesion after the first, which is coded under 19285.
© Copyright 2025 Coding Ahead. All rights reserved.
The placement of breast localization devices is indicated for various clinical scenarios where precise identification of breast lesions is necessary prior to surgical procedures. The following conditions may warrant this procedure:
The procedure for placing breast localization devices involves several critical steps to ensure accurate placement and identification of the lesion. The following procedural steps are outlined:
After the placement of the breast localization device, the patient may be monitored for any immediate complications. It is essential to provide post-procedure care instructions, which may include avoiding strenuous activities and monitoring the insertion site for signs of infection or unusual discomfort. The localization device will assist the surgeon in accurately locating the lesion during the subsequent surgical procedure, ensuring effective treatment. Follow-up appointments may be scheduled to assess the site and discuss the results of the biopsy or surgery.
| Short Descr | PERQ DEV BREAST ADD US IMAG | Medium Descr | PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE | Long Descr | Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure) | Status Code | Active Code | Global Days | ZZZ - Code Related to Another Service | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 0 - No payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 0 - Payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Items and Services Packaged into APC Rates | ASC Payment Indicator | Packaged service/item; no separate payment made. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1A - Major procedure - breast | MUE | 2 |
This is an add-on code that must be used in conjunction with one of these primary codes.
| 19285 | MPFS Status: Active Code APC Q1 ASC N1 Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including ultrasound guidance |
| RT | Right side (used to identify procedures performed on the right side of the body) | LT | Left side (used to identify procedures performed on the left side of the body) | X5 | Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CC | Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed) | GC | This service has been performed in part by a resident under the direction of a teaching physician | GZ | Item or service expected to be denied as not reasonable and necessary | Q6 | Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area | X4 | Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XP | Separate practitioner, a service that is distinct because it was performed by a different practitioner | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
|
Date
|
Action
|
Notes
|
|---|---|---|
| 2014-01-01 | Added | Added |
Get instant expert-level medical coding assistance.