Overview of CPT Code 19085: Breast Biopsy, Stereotactic Guidance

Overview of CPT Code 19085: Breast Biopsy, Stereotactic Guidance

CPT Code 19085 refers to a breast biopsy performed with stereotactic guidance, a minimally invasive procedure used to obtain tissue samples from suspicious breast lesions identified through imaging techniques.

When CPT Code 19085 is Used?

This procedure is indicated in various clinical scenarios.

• Presence of a suspicious mass or lesion detected on a mammogram.
• Microcalcifications identified on imaging that require further evaluation.
• Follow-up of previously identified abnormalities that have changed in appearance.

Symptoms Indicating This Procedure

Patients may report specific symptoms or findings that lead to the need for this biopsy.

• Palpable lump or mass in the breast.
• Changes in breast shape or size.
• Nipple discharge that is bloody or clear.

Causes and Risk Factors

Several factors may contribute to the development of breast lesions.

• Family history of breast cancer.
• Genetic mutations such as BRCA1 or BRCA2.
• Previous breast biopsies or surgeries.

Diagnostic Tests Before Procedure

Prior to the biopsy, certain tests are performed to guide the procedure.

• Mammography to identify the location of the lesion.
• Ultrasound to assess the characteristics of the mass.
• MRI for detailed imaging of complex cases.

Procedure Description

The procedure involves several key steps to ensure accurate tissue sampling.

• Patient is positioned comfortably, usually lying face down.
• Stereotactic imaging is used to locate the lesion precisely.
• Local anesthesia is administered to minimize discomfort.
• A small incision is made, and a biopsy needle is inserted to obtain tissue samples.
• The samples are collected and sent for pathological analysis.

Preparation for the Procedure

Patients should follow specific guidelines to prepare for the biopsy.

• Avoid blood thinners such as aspirin or ibuprofen a few days prior.
• Inform the physician of any allergies or medical conditions.
• Wear comfortable clothing and arrange for transportation if sedation is used.

Recovery and Aftercare

Post-procedure care is essential for optimal recovery.

• Rest for the remainder of the day after the procedure.
• Apply ice packs to reduce swelling and discomfort.
• Follow up with the physician for results and further instructions.

Possible Complications

While generally safe, there are potential risks associated with the procedure.

• Bleeding or hematoma at the biopsy site.
• Infection at the incision site.
• Discomfort or pain in the breast area.

Secure, compliant, and built for trust

HIPAA-compliant and designed with privacy in mind, your patient’s data is protected. Focus on care while we safeguard your information.

Learn more

Post-Procedure Follow-Up

Monitoring after the procedure is crucial for patient safety.

• Schedule a follow-up appointment within a week to discuss results.
• Monitor for any signs of infection or unusual symptoms.
• Regular breast examinations as recommended by the physician.

Alternative Treatments

There are non-surgical options available for managing breast lesions.

• Watchful waiting with regular imaging follow-ups.
• Medications for hormonal therapy in specific cases.
• Thermal ablation techniques for certain types of lesions.

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

Educating patients on breast health is vital for prevention.

• Regular self-breast examinations.
• Annual mammograms as recommended based on age and risk factors.
• Healthy lifestyle choices to reduce breast cancer risk.

Billing and Coding Information

CPT Code: 19085

Category: Surgical Procedures

Common Modifiers:

• -26
• -TC

Average Cost and Insurance Coverage

Understanding the financial aspects of the procedure is important.

• Average cost ranges from $1,000 to $3,000 depending on facility and location.
• Most insurance plans cover the procedure if deemed medically necessary.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 19083 - Breast Biopsy, Stereotactic, Needle
• 19086 - Breast Biopsy, Stereotactic, with Placement of Localization Device
• 19100 - 'Excision of breast lesion'
• 19101 - Biopsy of breast, percutaneous, needle
• 19120 - Excision of Breast Lesion

References and Sources

• Breast Biopsy Techniques
• Understanding Stereotactic Breast Biopsy
• Breast Health and Screening