Overview of CPT Code 19081: Breast Biopsy, Needle, Image-Guided
CPT Code 19081 refers to a minimally invasive procedure where a needle is used to obtain a tissue sample from the breast, guided by imaging techniques such as ultrasound or mammography. This procedure is essential for diagnosing breast abnormalities.
When CPT Code 19081 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a suspicious breast mass or lump identified on imaging.
- Abnormal findings on a mammogram that require further investigation.
- Evaluation of breast tissue in patients with a family history of breast cancer.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant a breast biopsy.
- A palpable lump or mass in the breast.
- Changes in breast shape or size.
- Nipple discharge that is bloody or clear.
- Skin changes over the breast, such as dimpling or puckering.
Causes and Risk Factors
Several factors can increase the likelihood of breast abnormalities.
- Family history of breast cancer.
- Genetic mutations such as BRCA1 or BRCA2.
- Previous breast biopsies or surgeries.
- Age, particularly women over 40.
Diagnostic Tests Before Procedure
Prior to the biopsy, several diagnostic tests may be performed.
- Mammography to identify suspicious areas.
- Ultrasound to assess the characteristics of the lump.
- MRI for detailed imaging of breast tissue.
Procedure Description
The procedure is performed in a clinical setting with imaging guidance.
- Patient is positioned comfortably, and the area is cleaned.
- Imaging guidance (ultrasound or mammography) is used to locate the abnormal tissue.
- A local anesthetic is administered to numb the area.
- A thin needle is inserted through the skin to obtain tissue samples.
- The samples are sent to a laboratory for analysis.
Preparation for the Procedure
Patients should follow specific guidelines before the biopsy.
- Inform the doctor about any medications being taken.
- Avoid blood thinners or aspirin a few days prior to the procedure.
- Wear comfortable clothing and avoid applying lotions or deodorants on the day of the procedure.
Recovery and Aftercare
Post-procedure care is crucial for recovery.
- Rest for the remainder of the day after the procedure.
- Apply ice packs to reduce swelling and discomfort.
- Keep the biopsy site clean and dry, and follow any specific wound care instructions.
- Over-the-counter pain relievers may be used as needed.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Bleeding or bruising at the biopsy site.
- Infection at the site of the biopsy.
- Discomfort or pain following the procedure.
- Possible changes in breast appearance.
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Post-Procedure Follow-Up
Follow-up care is important to monitor recovery and results.
- Schedule a follow-up appointment within a week to discuss biopsy results.
- Monitor the biopsy site for any signs of infection or complications.
- Follow up with imaging studies as recommended by the physician.
Alternative Treatments
There are non-surgical options for managing breast abnormalities.
- Regular monitoring with imaging for benign conditions.
- Medications for hormonal imbalances.
- Lifestyle changes to reduce risk factors.
Home Care Tips
Patients can take simple steps to aid recovery at home.
- Avoid strenuous activities for a few days post-procedure.
- Keep the biopsy site clean and dry.
- Use ice packs to manage swelling and discomfort.
Patient Education & Prevention
Education is key to preventing breast issues.
- Regular breast self-exams to detect changes early.
- Routine mammograms as recommended based on age and risk factors.
- Discuss family history and risk factors with a healthcare provider.
Billing and Coding Information
CPT Code: 19081
Category: Surgical Procedures
Common Modifiers:
- -26
- -TC
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,000 to $3,000.
- Most insurance plans cover the procedure if deemed medically necessary.
Related CPT Codes
- 19082 - Breast Biopsy, Needle, Percutaneous, Image-Guided
- 19083 - Breast Biopsy, Stereotactic, Needle
- 19100 - 'Excision of breast lesion'
- 19101 - Biopsy of breast, percutaneous, needle
- 19120 - Excision of Breast Lesion
References and Sources
Frequently Asked Questions (FAQs)
Is the breast biopsy painful?
Most patients experience minimal discomfort during the procedure due to local anesthesia.
How long does it take to get biopsy results?
Results typically take a few days to a week, depending on the laboratory.
Can I drive after the procedure?
Yes, you can usually drive yourself home after the biopsy.
What should I do if I notice bleeding?
If bleeding persists or worsens, contact your healthcare provider immediately.
