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19290 and 19295

  1. #1
    New Haven, CT
    Question 19290 and 19295
    Medical Coding Books
    There is no radiology forum, so I'm putting this in surgical . . hoping someone might have some input. Seems somewhere I read that code +19295 (image guided placement of localization clip, is rolled into 19290 (placement of needle local wire) in breast biopsy procedures. Does anyone have any insight. Can these two codes be coded together ?

  2. #2
    St. Louis, Missouri
    I don't code radiology but looking in the CPT book under code +19295 it states to use 19295 in conjunction with 19102, 19103. I hope this helps.

    Melissa Blow, CPC

  3. #3
    19290 is when the needle loc wire is placed preoperatively in the radiology dept and this code is billed by the radiologist - then the pt is brought to OR for biopsy/excision.
    In 19295, usually we bill this when we are doing a mammotome biopsy - 19103 and the surgeon placeds the marker clip during the biopsy.
    Hope that helps.
    Mary Beth Gord, CPC

  4. #4
    Default breast biopsy
    19295 - is an add-on procedure of placing a metallic clip before a breast biopsy procedure (19102 or 19103)
    19290 - is the placement of a needle localization wire (Hawkins wire) to assist in the identification of the suspect tissue.

    In my experience as a radiology coder, 19295 always go hand in hand as an add-on procedure for a percutaneous core biopsy 19102 or an automated vacuum assisted or mammotome probe biopsy 19103.
    19290 is a separate preoperative procedure.

  5. Default it is clip used in biopsy
    19295 is an add on code and it should not be billed seperately

    acctually it is a clip used during the proceedure to locate the neddle for biopsy of lesion, comfortablly

    should be added with 19102 and 19103

    hope this will be helpfull for u


  6. #6
    These codes can be billed together but you would attach mod 59 to 19295. Hopefully this helps.

    Purvi, CPC

  7. Default
    no modifier on add-on codes, you would not use 59

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