Overview of CPT Code 19101:biopsy-of-breast-percutaneous-needle

Overview of CPT Code 19101:biopsy-of-breast-percutaneous-needle

CPT Code 19101 refers to a percutaneous needle biopsy of the breast, a minimally invasive procedure used to obtain tissue samples from breast lesions for diagnostic purposes.

When CPT Code 19101 is Used?

This procedure is indicated in various clinical scenarios.

• Suspicious breast mass detected on imaging studies.
• Abnormal findings on a clinical breast exam.
• Follow-up of previously identified breast lesions.
• Assessment of breast tissue in patients with a family history of breast cancer.

Symptoms Indicating This Procedure

Patients may present with specific symptoms that warrant a biopsy.

• 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 redness.

Causes and Risk Factors

Understanding the causes and risk factors can help in identifying patients who may need this procedure.

• Family history of breast cancer.
• Genetic mutations such as BRCA1 or BRCA2.
• Previous breast biopsies or surgeries.
• Age over 40 years.

Diagnostic Tests Before Procedure

Several tests may be performed to guide the need for a biopsy.

• Mammography to identify suspicious areas.
• Ultrasound to evaluate breast masses.
• MRI of the breast for further assessment.
• Fine needle aspiration cytology (FNAC) if indicated.

Procedure Description

The procedure is performed under local anesthesia.

• Patient is positioned comfortably, usually lying on their back.
• The skin over the biopsy site is cleaned and sterilized.
• Local anesthesia is administered to numb the area.
• A thin needle is inserted into the breast tissue to obtain a sample.
• Multiple samples may be taken to ensure adequate tissue for diagnosis.
• The needle is removed, and pressure is applied to minimize bleeding.

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 a few days prior.
• Wear comfortable clothing and avoid wearing deodorant on the day of the procedure.
• Arrange for someone to drive home if sedation is used.

Recovery and Aftercare

Post-procedure care is essential for proper healing.

• 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.
• Follow up with the doctor for results and further instructions.

Possible Complications

While complications are rare, they can occur.

• Bleeding at the biopsy site.
• Infection at the site of the procedure.
• Hematoma formation.
• Discomfort or pain in the breast.

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.

• Schedule a follow-up appointment within a week to discuss results.
• Monitor for any signs of infection or excessive bleeding.
• Follow up with imaging studies if recommended.

Alternative Treatments

There are non-surgical options available.

• Observation and regular monitoring of benign lesions.
• Medications for hormonal therapy in certain breast conditions.
• Lifestyle changes to reduce breast cancer risk.

Home Care Tips

Patients can take steps to aid recovery at home.

• Avoid strenuous activities for a few days.
• Use over-the-counter pain relievers as needed.
• Keep the biopsy site clean and dry.
• Monitor for any unusual symptoms and contact the doctor if they occur.

Patient Education & Prevention

Education is key to prevention and early detection.

• Regular breast self-exams to detect changes early.
• Annual mammograms starting at age 40 or earlier if at high risk.
• Healthy lifestyle choices, including diet and exercise.
• Genetic counseling for those with a family history of breast cancer.

Billing and Coding Information

CPT Code: 19101

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 $1,000 to $3,000.
• Most insurance plans cover the procedure if deemed medically necessary.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 19100 - 'Excision of breast lesion'
• 19102 - Excision of Breast Lesion
• 19281 - Breast Biopsy, Needle, Percutaneous
• 19283 - Placement of Breast Tissue Expander
• 19301 - Breast Reconstruction, Unilateral

References and Sources

• Breast Biopsy Overview
• Understanding Breast Biopsy