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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a hooked wire is inserted at a perpendicular angle to the lesion, remaining anchored in place as the needle is withdrawn, with a portion of the wire extending outside the skin.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.
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The placement of breast localization device(s) is indicated for the following conditions:
The procedure for the placement of breast localization device(s) involves several key steps to ensure accurate localization of the lesion.
Post-procedure care involves monitoring the patient for any immediate complications related to the localization device placement. Patients may be advised to avoid strenuous activities for a short period following the procedure. The localization device will remain in place until the surgical procedure is performed, and the patient should be informed about the importance of keeping the area clean and reporting any unusual symptoms, such as excessive swelling or pain, to their healthcare provider. Follow-up imaging may be required to ensure the device remains correctly positioned prior to surgery.
| Short Descr | PERQ DEV BREAST ADD MR GUIDE | Medium Descr | PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID | Long Descr | 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) | 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.
| 19287 | 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 magnetic resonance guidance |
| 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. | 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. | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right 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 | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2014-01-01 | Added | Added |
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