Overview of CPT Code 10011: Fine Needle Aspiration Biopsy, Breast
CPT Code 10011 refers to a fine needle aspiration biopsy of the breast, a minimally invasive procedure used to obtain tissue samples from breast lesions for diagnostic purposes.
When CPT Code 10011 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a palpable breast mass or lump.
- Abnormal findings on a mammogram or breast ultrasound.
- Evaluation of suspicious breast lesions.
- Monitoring known breast conditions.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant this procedure.
- A lump or mass in the breast.
- Changes in breast shape or size.
- Nipple discharge that is bloody or clear.
- Skin changes over the breast area.
Causes and Risk Factors
Several factors can contribute to the need for a fine needle aspiration biopsy.
- Family history of breast cancer.
- Personal history of breast disease.
- Age over 40 years.
- Genetic mutations such as BRCA1 or BRCA2.
Diagnostic Tests Before Procedure
Prior to the biopsy, certain tests may be conducted.
- Mammography to identify abnormalities.
- Breast ultrasound to assess the characteristics of the lesion.
- MRI of the breast for detailed imaging.
Procedure Description
The fine needle aspiration biopsy involves several key steps.
- Patient is positioned comfortably, usually lying on their back.
- The skin over the biopsy site is cleaned with antiseptic.
- A thin, hollow needle is inserted into the breast lesion.
- Tissue samples are aspirated into the needle.
- The needle is removed, and pressure is applied to the site.
Preparation for the Procedure
Patients should follow specific guidelines before the biopsy.
- Inform the doctor about any medications being taken.
- Avoid blood thinners like aspirin or ibuprofen prior to the procedure.
- Wear comfortable clothing and avoid wearing deodorant on the day of the procedure.
Recovery and Aftercare
Post-procedure care is essential for recovery.
- Rest for the remainder of the day after the procedure.
- Apply ice packs to reduce swelling if needed.
- Monitor the biopsy site for signs of infection.
- Follow up with the healthcare provider for results.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Bleeding at the biopsy site.
- Infection at the site of aspiration.
- Bruising or discomfort in the breast.
- Inadequate sample leading to the need for repeat biopsy.
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Post-Procedure Follow-Up
Follow-up care is crucial for monitoring.
- Schedule a follow-up appointment within a week to discuss results.
- Monitor for any unusual symptoms or complications.
- Further imaging or procedures may be recommended based on results.
Alternative Treatments
There are non-surgical options available for breast conditions.
- Observation and regular monitoring of benign lesions.
- Medications for hormonal therapy in certain breast conditions.
- Ultrasound-guided core needle biopsy as an alternative.
Home Care Tips
Patients can take simple steps to aid recovery at home.
- Keep the biopsy site clean and dry.
- Avoid strenuous activities for a few days.
- Take over-the-counter pain relief as needed.
Patient Education & Prevention
Education is key to prevention and early detection.
- Regular breast self-exams to detect changes early.
- Routine mammograms as recommended by healthcare providers.
- Discuss family history and risk factors with a doctor.
Billing and Coding Information
CPT Code: 10011
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- RT - Right side
- LT - Left side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $300 to $1,000.
- Most insurance plans cover the procedure if deemed medically necessary.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
- 10012 - Incision and drainage of cyst
- 19100 - 'Excision of breast lesion'
- 19101 - Biopsy of breast, percutaneous, needle
- 19120 - Excision of Breast Lesion
- 19125 - Excision of breast lesion
References and Sources
Frequently Asked Questions (FAQs)
Is the fine needle aspiration biopsy painful?
Most patients report minimal discomfort during the procedure.
How long does the procedure take?
The procedure typically takes about 15 to 30 minutes.
When will I get the results?
Results are usually available within a few days to a week.
Can I drive after the procedure?
Yes, you can usually drive unless advised otherwise by your doctor.
