Overview of CPT Code 19105:breast-biopsy-needle

Overview of CPT Code 19105:breast-biopsy-needle

CPT Code 19105 refers to a needle biopsy of the breast, a minimally invasive procedure used to obtain tissue samples from suspicious breast lesions for diagnostic purposes.

When CPT Code 19105 is Used?

This procedure is indicated in various clinical scenarios.

• Presence of a palpable breast mass or lump.
• Abnormal findings on a mammogram.
• Suspicious breast ultrasound results.
• Monitoring of known breast lesions.

Symptoms Indicating This Procedure

Patients may report several symptoms that warrant a breast biopsy.

• 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, such as dimpling or puckering.

Causes and Risk Factors

Several factors can contribute to the need for a breast biopsy.

• Family history of breast cancer.
• Personal history of breast disease.
• Age, particularly women over 40.
• Genetic mutations such as BRCA1 and BRCA2.

Diagnostic Tests Before Procedure

Prior to the biopsy, several diagnostic tests may be performed.

• Mammography to identify suspicious areas.
• Breast ultrasound to evaluate masses.
• MRI of the breast for detailed imaging.
• Fine needle aspiration cytology if indicated.

Procedure Description

The needle biopsy procedure involves several key steps.

• Patient is positioned comfortably, usually lying on their back.
• The area of the breast is cleaned and sterilized.
• Local anesthesia is administered to numb the area.
• A thin needle is inserted into the breast to obtain tissue samples.
• 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 of any medications being taken, especially blood thinners.
• Avoid aspirin or anti-inflammatory medications for 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 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.
• Follow up with the doctor for results and further instructions.

Possible Complications

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

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

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Post-Procedure Follow-Up

Follow-up care is crucial for monitoring recovery.

• Schedule a follow-up appointment within a week to discuss results.
• Monitor the biopsy site for signs of infection.
• Report any unusual symptoms to the healthcare provider immediately.

Alternative Treatments

There are non-surgical options for managing breast concerns.

• Regular monitoring with imaging for benign lesions.
• Medications for hormonal therapy if indicated.
• Lifestyle changes to reduce breast cancer risk.

Home Care Tips

Patients can take simple steps to aid recovery at home.

• Avoid strenuous activities for a few days.
• Wear a supportive bra to minimize discomfort.
• Stay hydrated and maintain a balanced diet.
• Follow all post-procedure instructions from the healthcare provider.

Patient Education & Prevention

Education is key to prevention and early detection.

• Perform regular breast self-exams.
• Schedule routine mammograms as recommended.
• Discuss family history with a healthcare provider.
• Adopt a healthy lifestyle to reduce risk factors.

Billing and Coding Information

CPT Code: 19105

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 medically necessary.
• Check with your insurance provider for specific coverage details.

Related CPT Codes

• 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

• Breast Biopsy Overview
• Understanding Breast Biopsy
• Breast Biopsy Procedures