Overview of CPT Code 19162: Breast Biopsy, Needle, Percutaneous
CPT Code 19162 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 19162 is Used?
This procedure is indicated in various clinical scenarios.
- Suspicious breast mass detected on imaging studies.
- Abnormal findings on a mammogram.
- Palpable breast lump that requires histological evaluation.
- Monitoring of known breast lesions.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant a 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 redness.
Causes and Risk Factors
Several factors may increase the likelihood of breast abnormalities.
- Family history of breast cancer.
- Genetic mutations (e.g., BRCA1, BRCA2).
- Age over 50.
- Previous breast biopsies or cancer.
Diagnostic Tests Before Procedure
Prior to the biopsy, certain tests may be conducted.
- Mammography to identify suspicious areas.
- Ultrasound to guide the biopsy.
- MRI for detailed imaging of breast tissue.
Procedure Description
The 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 lesion under imaging guidance.
- Tissue samples are collected and sent for pathological analysis.
Preparation for the Procedure
Patients should follow specific guidelines before the biopsy.
- Inform the doctor about any medications being taken.
- Avoid blood thinners for a few days prior to the procedure.
- 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 doctor for results and further instructions.
Possible Complications
While generally safe, there are potential risks.
- 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.
- Report any unusual symptoms such as excessive bleeding or fever.
- Regular breast examinations as advised by the healthcare provider.
Alternative Treatments
Other management options may be considered.
- Watchful waiting for benign lesions.
- Medication for hormonal therapy in certain cases.
- Surgical excision for larger or suspicious masses.
Home Care Tips
Patients can take steps to aid recovery at home.
- Avoid strenuous activities for a few days.
- Take over-the-counter pain relievers as needed.
- Monitor the biopsy site for signs of infection.
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: 19162
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
- 19161 - Breast Biopsy, Needle, Percutaneous
- 19281 - Breast Biopsy, Needle, Percutaneous
- 19283 - Placement of Breast Tissue Expander
- 19301 - Breast Reconstruction, Unilateral
References and Sources
Frequently Asked Questions (FAQs)
Is the biopsy painful?
Most patients experience minimal discomfort during the procedure.
How long does the procedure take?
The biopsy typically takes about 30 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.
