Overview of CPT Code 19186:breast-biopsy-percutaneous-needle
CPT Code 19186 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 19186 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 for changes.
Symptoms Indicating This Procedure
Patients may report several symptoms that warrant a biopsy.
- A 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
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 history.
Diagnostic Tests Before Procedure
Prior to the biopsy, certain tests may be performed.
- Mammography to identify suspicious areas.
- Ultrasound to guide the biopsy.
- MRI for detailed imaging of breast tissue.
- Clinical breast examination.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, usually lying on their back.
- Skin over the biopsy site is cleaned and numbed with local anesthesia.
- A thin needle is inserted into the breast lesion under imaging guidance.
- Tissue samples are collected through the needle.
- The needle is removed, and a small bandage is applied.
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.
- Arrange for transportation 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.
- Keep the biopsy site clean and dry.
- Follow up with the doctor for results and further instructions.
Possible Complications
While generally safe, some risks are 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
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.
- 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.
- Routine mammograms as recommended based on age and risk factors.
- Healthy lifestyle choices, including diet and exercise.
- Genetic counseling for those with a family history of breast cancer.
Billing and Coding Information
CPT Code: 19186
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 $1,000 to $3,000.
- Most insurance plans cover the procedure if deemed medically necessary.
- Out-of-pocket costs may apply depending on the insurance plan.
Related CPT Codes
- 19185 - Breast Biopsy, Stereotactic, Needle
- 19187 - Breast Biopsy, Stereotactic
- 19281 - Breast Biopsy, Needle, Percutaneous
- 19283 - Placement of Breast Tissue Expander
- 19301 - Breast Reconstruction, Unilateral
References and Sources
Frequently Asked Questions (FAQs)
Is the breast biopsy painful?
Most patients experience minimal discomfort during the procedure.
How long does it take to get biopsy results?
Results are typically available within a few days to a week.
Can I drive after the procedure?
If local anesthesia is used, you should be able to drive; however, if sedation is used, arrange for a ride home.
What should I do if I notice bleeding?
Apply gentle pressure and contact your healthcare provider if bleeding persists.
