General Surgery Coding Alert
Guide Breast Biopsy Choice by Method
Question: Our surgeon performed a "stereotactic needle core biopsy" of breast tissue, removing three separate biopsies. What is the correct coding for this procedure? Mississippi Subscriber Answer: The correct coding is 19081 (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 stereotactic guidance) and two units of +19082 (...each additional lesion, including stereotactic guidance (List separately in addition to code for primary procedure)). You would use the same coding for stereotactic-guided breast biopsy whether the surgeon uses a needle to remove the biopsy core, or a different procedure, such as an automated vacuum assisted or rotating biopsy device. The key to these codes is that the procedure involves a three-dimensional "stereotactic" guidance for a percutaneous breast biopsy. Use one code for each biopsy specimen removed. Other codes describe different guidance methods for breast biopsy, such as 19083 and +19084 for ultrasound guidance, and 19085 and +19086 for magnetic resonance guidance. Caution: Unlike older, deleted codes for breast biopsy, you cannot separately report the radiological supervision and interpretation. Instead, codes 19081 and +19082 include the stereotactic guidance.
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