CPT code 19085 refers to a procedure where a small piece of tissue is taken from the breast to check for any signs of disease. This also involves placing a marker in the breast to guide the process, and it may include taking images to ensure accuracy. CPT 19085 represents “Biopsy, breast, with placement of breast localization device(s) (eg, clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous; first lesion, including magnetic resonance guidance.”
Procedure Explanation:
This procedure involves using a needle to remove a sample from the breast. During the process, a small device, like a clip, is placed in the breast to help locate the area. Imaging might be used to guide the needle to the correct spot, ensuring the right tissue is sampled. This specific code is used when the first area is being biopsied, and magnetic imaging is involved. While the procedure may include placing localizers and taking images, it does not cover additional lesions or different imaging methods.
Common Names:
- Breast core needle biopsy with localization
- Image-guided breast biopsy
- Needle biopsy of the breast with marker placement
Relative Value Units (RVU):
The RVUs associated with this code are 3.64.
How This Procedure Appears:
- Operating Room Schedule Name: Needle biopsy with marker placement and MRI guidance
- Surgical Consent Form Name: Breast biopsy with localization and MRI guidance
Typical Patients and Diagnoses:
This procedure is generally performed for patients who have been identified to have suspicious lumps or irregular areas in the breast during a screening mammogram or physical exam. It’s often used in cases where there is a concern of breast cancer or other abnormalities that need further examination. For example, a woman who has felt a new lump during a self-exam, or one whose mammogram showed an unclear spot would typically undergo this biopsy.
Associated ICD-10 Codes:
- N63: This code is used when there is an unspecified lump in the breast, meaning a lump whose nature is not immediately clear and requires further investigation.
- C50.911: This code indicates a malignant neoplasm, or cancerous tumor, of an unspecified site in the right breast, often used when there’s a suspicion of cancer.
- D48.60: This code is for a neoplasm of uncertain behavior in breast tissue, meaning it’s not yet clear if the tumor is benign (non-cancerous) or malignant (cancerous).
Summary
In summary, code 19085 describes a breast biopsy procedure that includes using a needle and imaging techniques to get a tissue sample, while placing a localization marker. Typical ICD-10 codes associated with 19085 include N63 (lump in the breast) and C50.911 (cancer in right breast, unspecified site).
Disclaimer
This post is for informational purposes only and is not a substitute for medical advice. “CPT” and CPT Codes are registered trademarks of the American Medical Association. HCPCS codes are managed by Medicare and are not subject to copyright.