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Code deleted, see 19081-19086, 19281-19288

Official Description

Preoperative placement of needle localization wire, breast; see 19281-19288

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 19290 refers to the preoperative placement of a needle localization wire in the breast. This procedure is performed with the aid of imaging guidance, which may include techniques such as ultrasound or mammography. The primary objective of this procedure is to accurately locate a targeted mass within the breast tissue. During the procedure, a physician inserts a hollow needle through the skin of the breast, positioning it directly over the identified mass. Inside this needle, a guidewire is threaded and advanced into the mass itself. This guidewire serves as a marker, allowing the surgeon to precisely locate the mass during subsequent surgical interventions, such as an excision or biopsy, which will occur in a separate operative session. The use of needle localization is particularly important in cases where the mass is not palpable or is difficult to visualize, ensuring that the surgical team can effectively target the area of concern for further evaluation or treatment.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 19290 is indicated for various clinical scenarios where precise localization of a breast mass is necessary prior to surgical intervention. The following conditions may warrant the use of needle localization:

  • Non-palpable breast lesions - These are masses that cannot be felt during a physical examination, making imaging guidance essential for accurate targeting.
  • Suspicious findings on imaging studies - Lesions that appear abnormal on mammograms or ultrasounds may require localization to confirm diagnosis through biopsy or excision.
  • Guidance for surgical excision - When a mass needs to be surgically removed, localization ensures that the surgeon can accurately locate the area of concern, minimizing damage to surrounding healthy tissue.

2. Procedure

The procedure for the preoperative placement of a needle localization wire involves several critical steps to ensure accuracy and safety. The following outlines the procedural steps as described:

  • Step 1: Patient Preparation The patient is positioned comfortably, and the breast area is cleaned and sterilized to reduce the risk of infection. Imaging guidance is selected based on the location and characteristics of the mass.
  • Step 2: Imaging Guidance The physician utilizes imaging techniques, such as ultrasound or mammography, to visualize the targeted mass. This step is crucial for determining the precise location for needle insertion.
  • Step 3: Needle Insertion A hollow needle is carefully inserted through the skin of the breast, directly over the identified mass. The physician ensures that the needle is accurately positioned to avoid any surrounding structures.
  • Step 4: Guidewire Placement Once the needle is in place, a guidewire is threaded through the needle and advanced into the mass. This guidewire will serve as a marker for the surgeon during the subsequent procedure.
  • Step 5: Confirmation The physician may perform additional imaging to confirm that the guidewire is correctly positioned within the mass. This step is essential to ensure that the localization is accurate before the patient is taken for surgery.
  • Step 6: Dressing and Post-Procedure Care After successful placement, the needle is removed, and a dressing is applied to the insertion site. The patient is then monitored for any immediate complications before being prepared for the next steps in their treatment plan.

3. Post-Procedure

Following the placement of the needle localization wire, the patient may experience some discomfort or tenderness at the insertion site. It is important for the healthcare team to provide instructions regarding care for the site, including keeping it clean and dry. The patient will typically be scheduled for the surgical procedure to excise or biopsy the mass in a separate session. During this time, the surgical team will utilize the guidewire to accurately locate the targeted mass. Patients should be informed about potential signs of complications, such as increased pain, swelling, or signs of infection, and advised to contact their healthcare provider if these occur. Overall, the post-procedure phase is crucial for ensuring a smooth transition to the subsequent surgical intervention.

Short Descr PLACE NEEDLE WIRE BREAST
Medium Descr PREOP PLACEMENT LOCALIZATION WIRE BREAST
Long Descr Preoperative placement of needle localization wire, breast;
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 1 - 150% payment adjustment for bilateral procedures applies.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory 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 STV-Packaged Codes
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P1G - Major procedure - Other
MUE Not applicable/unspecified.
CCS Clinical Classification 165 - Breast biopsy and other diagnostic procedures on breast
Date
Action
Notes
2014-01-01 Deleted Code deleted, see 19081-19086, 19281-19288
2011-01-01 Changed Short description changed.
2010-01-01 Changed Code description changed.
1993-01-01 Added Code added.
Code
Description