Overview of CPT Code 19086: Breast Biopsy, Stereotactic, with Placement of Localization Device
CPT Code 19086 refers to a stereotactic breast biopsy procedure that involves the use of imaging technology to guide the biopsy needle to a specific area of the breast. This procedure is typically performed when a suspicious area is detected on a mammogram or other imaging studies.
When CPT Code 19086 is Used?
This procedure is indicated in various clinical scenarios.
- Abnormal mammogram findings requiring tissue sampling.
- Presence of a palpable breast mass.
- Microcalcifications detected on imaging.
- Follow-up of previously identified lesions.
Symptoms Indicating This Procedure
Patients may report several symptoms that lead to the need for this biopsy.
- 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 may contribute to the need for a stereotactic breast biopsy.
- Family history of breast cancer.
- Personal history of breast abnormalities.
- Age over 40 years.
- Genetic mutations such as BRCA1 or BRCA2.
Diagnostic Tests Before Procedure
Prior to the biopsy, certain tests are performed to guide the procedure.
- Mammography to identify suspicious areas.
- Ultrasound to assess the characteristics of the lesion.
- MRI for detailed imaging if indicated.
Procedure Description
The procedure is performed under local anesthesia and involves several steps.
- Patient is positioned comfortably, usually lying face down.
- Stereotactic imaging is used to locate the area of concern.
- Local anesthesia is administered to numb the breast.
- A small incision is made, and a biopsy needle is inserted.
- Tissue samples are collected and sent for pathological analysis.
- A localization device may be placed to mark the biopsy site.
Preparation for the Procedure
Patients should follow specific guidelines before the biopsy.
- Avoid blood thinners for several days prior to the procedure.
- Inform the doctor of any allergies or medications.
- Wear comfortable clothing and avoid wearing deodorant or lotions 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.
- Keep the biopsy site clean and dry.
- Follow up with the healthcare provider for results and further instructions.
Possible Complications
While generally safe, there are potential risks associated with the procedure.
- Bleeding at the biopsy site.
- Infection.
- Hematoma formation.
- Discomfort or pain at the site.
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Post-Procedure Follow-Up
Monitoring after the procedure is crucial.
- Schedule a follow-up appointment within a week to discuss results.
- Monitor for any signs of infection or complications.
- Regular breast examinations as recommended by the healthcare provider.
Alternative Treatments
There are non-surgical options available for breast abnormalities.
- Watchful waiting for benign findings.
- Medication for hormonal imbalances.
- Ultrasound-guided aspiration for cysts.
Home Care Tips
Patients can take simple steps to aid recovery at home.
- Avoid strenuous activities for a few days.
- Take over-the-counter pain relievers as needed.
- Keep the biopsy site clean and dry.
Patient Education & Prevention
Education is key to prevention and early detection.
- Regular breast self-exams.
- Annual mammograms as recommended.
- Healthy lifestyle choices to reduce cancer risk.
Billing and Coding Information
CPT Code: 19086
Category: Surgical Procedures
Common Modifiers:
- 50 - Bilateral procedure
- LT - Left side
- RT - Right side
Average Cost and Insurance Coverage
Costs can vary based on location and insurance.
- Average cost ranges from $1,500 to $3,000.
- Most insurance plans cover the procedure if medically necessary.
- Check with your insurance provider for specific coverage details.
Related CPT Codes
- 19085 - Breast Biopsy, Stereotactic Guidance
- 19100 - 'Excision of breast lesion'
- 19101 - Biopsy of breast, percutaneous, needle
- 19102 - Excision of Breast Lesion
- 19103 - Excision of breast lesion, malignant
References and Sources
Frequently Asked Questions (FAQs)
Is the procedure painful?
Most patients experience minimal discomfort due to local anesthesia.
How long does the procedure take?
The biopsy typically takes about 30 to 60 minutes.
When will I get my results?
Results are usually available within a week.
Can I drive after the procedure?
It is advisable to have someone drive you home.
