CPT® Code 77031 | Case2Code

Official Description

Stereotactic localization guidance for breast biopsy or needle placement (eg, for wire localization or for injection), each lesion, radiological supervision and interpretation

Common Language Description

The CPT® Code 77031 refers to the process of stereotactic localization guidance specifically for breast biopsy or needle placement procedures. This code encompasses the radiological supervision and interpretation required for the procedure involving a single lesion. Stereotactic localization is a sophisticated imaging technique that employs a fixed coordinate system to accurately pinpoint the location of a lesion within the breast. This is achieved by defining the lesion's position using specific x, y, and z coordinates, which are relative to a predetermined reference point. During the procedure, the breast is carefully positioned between a compression plate and a supportive structure at the back, ensuring that the lesion remains in a stable and fixed position throughout the imaging process. The thickness of the breast under compression is a critical factor, as it determines the depth dimension of the lesion. Initially, an image is captured at a perpendicular angle of 0 degrees to the compression plate, which serves to center the lesion within the biopsy window of the compression plate. Following this, additional images are taken at various specified angles, rotating around the known center, allowing for geometric calculations to accurately determine the lesion's location in three-dimensional space. Ultimately, this precise localization enables the insertion of a needle into the lesion for biopsy, wire localization, or injection procedures, all guided by the established stereotactic coordinates.

1. Indications

The procedure associated with CPT® Code 77031 is indicated for the following conditions:

Breast Lesion Identification This procedure is performed to accurately locate and identify lesions within the breast that may require further investigation or intervention.
Biopsy Procedures It is indicated for patients who need a biopsy to determine the nature of a breast lesion, whether it is benign or malignant.
Wire Localization The procedure is also indicated for wire localization, which is often necessary prior to surgical excision of a lesion.
Injection Procedures Stereotactic localization may be indicated for injection procedures, such as administering medication directly into a lesion.

2. Procedure

The procedure for CPT® Code 77031 involves several critical steps to ensure accurate localization and intervention:

Step 1: Patient Positioning The patient is positioned with the breast placed between a compression plate and a supportive structure. This positioning is essential to stabilize the breast and keep the lesion in a fixed location during imaging.
Step 2: Initial Imaging An initial image is obtained at a perpendicular angle of 0 degrees to the compression plate. This image is crucial for centering the lesion within the biopsy window of the compression plate, providing a reference point for subsequent imaging.
Step 3: Additional Imaging Following the initial image, additional images are captured at specified angles relative to the 0-degree position. This involves rotating around the known center to gather comprehensive data about the lesion's location.
Step 4: Geometric Calculations Geometric calculations are performed using the images obtained to determine the precise three-dimensional location of the lesion. This step is vital for ensuring accurate needle placement.
Step 5: Needle Placement Finally, a needle is inserted into the lesion based on the established stereotactic coordinates. This step is performed for biopsy, wire localization, or injection procedures, guided by the precise localization achieved through the imaging process.

3. Post-Procedure

After the completion of the stereotactic localization guidance procedure, patients may be monitored for any immediate complications or side effects. It is essential to provide post-procedure care instructions, which may include recommendations for managing discomfort, signs of infection, and follow-up appointments for results or further interventions. Patients should be informed about the expected recovery process, which typically involves minimal downtime, allowing them to resume normal activities shortly after the procedure, depending on individual circumstances and the specific interventions performed.

Short Descr	STEREOTACT GUIDE FOR BRST BX
Medium Descr	STRTCTC LOCLZJ GID BREAST BX/NEEDLE PLACEMENT
Long Descr	Stereotactic localization guidance for breast biopsy or needle placement (eg, for wire localization or for injection), each lesion, radiological supervision and interpretation
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	1 - Diagnostic Tests for Radiology Services
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)	9 - Concept does not apply.
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
Type of Service (TOS)	4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS)	I1A - Standard imaging - chest
MUE	Not applicable/unspecified.
CCS Clinical Classification	226 - Other diagnostic radiology and related techniques