CPT® Code 77032 | Case2Code

Official Description

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

Common Language Description

This CPT® code 77032 pertains to the radiological supervision and interpretation involved in mammographic guidance for needle placement in the breast. Specifically, it is utilized when a needle is positioned within a single breast lesion, which may be necessary for various procedures, including wire localization or injection. The process begins with the identification of the area of concern, which is marked on the skin, and mammographic images are captured to visualize the breast tissue. These images serve as a guide for the precise advancement of the needle into the lesion. Following the needle placement, additional mammographic x-rays are taken to ensure that the needle is accurately positioned within the mass before any further procedures are conducted. This code is essential for documenting the radiological component of the procedure, which is typically reported alongside surgical codes that correspond to the actual intervention performed. In the case of wire localization, a hooked wire is inserted through the needle into the lesion at a perpendicular angle, remaining anchored within the mass while the needle is withdrawn. The wire, which extends slightly outside the skin, acts as a marker for subsequent surgical procedures, ensuring accurate targeting of the lesion during treatment.

1. Indications

The indications for using CPT® code 77032 include the following:

Needle Placement for Injection This procedure may be indicated when a therapeutic injection is required directly into a breast lesion.
Wire Localization This code is utilized when wire localization is necessary to mark a breast lesion for surgical excision or biopsy.
Identification of Lesions The procedure is indicated for the accurate identification and localization of breast lesions that may not be palpable during a physical examination.

2. Procedure

The procedure associated with CPT® code 77032 involves several critical steps to ensure accurate needle placement within the breast lesion.

Step 1: Marking the Area of Concern Initially, the area of concern is identified through clinical examination and imaging studies. The physician marks this area on the skin to provide a reference point for the needle placement.
Step 2: Mammographic Imaging Following the marking, mammographic images are obtained to visualize the breast tissue and the lesion. These images are crucial for guiding the needle accurately into the lesion.
Step 3: Needle Advancement Using the mammographic images as a guide, the physician advances the needle into the lesion. This step requires precision to ensure that the needle is correctly positioned within the mass.
Step 4: Confirmation of Placement After the needle is inserted, additional mammographic x-rays are taken to confirm that the needle is accurately placed within the lesion. This confirmation is essential before proceeding with any therapeutic intervention.
Step 5: Wire Localization (if applicable) In cases where wire localization is performed, a hooked wire is inserted through the needle into the lesion at a perpendicular angle. The wire remains anchored within the mass while the needle is withdrawn, with a short length of wire extending outside the skin to serve as a marker for subsequent surgical procedures.

3. Post-Procedure

Post-procedure care following the use of CPT® code 77032 typically involves monitoring the patient for any immediate complications related to the needle placement. Patients may be advised to avoid strenuous activities for a short period following the procedure. If wire localization was performed, the patient should be informed about the presence of the wire and any specific instructions regarding its care. Follow-up imaging or surgical intervention may be scheduled based on the findings from the procedure. It is also important for the healthcare provider to document the procedure thoroughly, including the confirmation of needle placement and any subsequent actions taken.

Short Descr	GUIDANCE FOR NEEDLE BREAST
Medium Descr	MAMMOGRAPHIC GID NEEDLE PLACEMENTT BREAST
Long Descr	Mammographic guidance for needle placement, breast (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