Overview of CPT Code 19260: Breast Biopsy, Needle Localization
CPT Code 19260 refers to a procedure where a needle is used to localize a breast lesion for biopsy. This technique is often employed when a breast abnormality is detected through imaging but cannot be felt during a physical examination.
When CPT Code 19260 is Used?
This procedure is indicated in various clinical scenarios.
- Presence of a suspicious breast mass detected on mammography or ultrasound.
- Need for tissue diagnosis of a non-palpable breast lesion.
- Follow-up of abnormal imaging findings that require histological evaluation.
Symptoms Indicating This Procedure
Patients may report several symptoms or findings that lead to this procedure.
- Abnormal mammogram results.
- Breast pain or discomfort.
- Palpable lump or mass in the breast.
- Changes in breast shape or size.
Causes and Risk Factors
Several factors may 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 abnormalities.
- Breast ultrasound for further evaluation.
- MRI of the breast in complex cases.
Procedure Description
The procedure involves several key steps.
- Patient is positioned comfortably, usually lying on their back.
- Local anesthesia is administered to numb the area.
- Imaging guidance (ultrasound or mammography) is used to locate the lesion.
- A thin needle is inserted into the breast to place a localization wire.
- The wire marks the area for biopsy, and a tissue sample is taken.
Preparation for the Procedure
Patients should follow specific guidelines before the procedure.
- Avoid blood thinners for several days prior to the procedure.
- Inform the doctor of any allergies, especially to anesthesia.
- 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 and discomfort.
- 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 or bruising at the biopsy site.
- Infection at the site of the needle insertion.
- Discomfort or pain in the breast area.
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 unusual symptoms.
- Regular breast examinations as advised by the healthcare provider.
Alternative Treatments
There are non-surgical options available for breast abnormalities.
- Regular monitoring with imaging for benign lesions.
- Medications for pain management or hormonal therapy.
- Lifestyle changes to reduce breast cancer risk.
Home Care Tips
Patients can take steps at home to aid recovery.
- Keep the biopsy site clean and dry.
- Avoid strenuous activities for a few days.
- Take over-the-counter pain relievers as needed.
Patient Education & Prevention
Education is key to prevention and early detection.
- Regular breast self-exams and clinical exams.
- Annual mammograms starting at age 40 or earlier if at high risk.
- Healthy lifestyle choices, including diet and exercise.
Billing and Coding Information
CPT Code: 19260
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.
- 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
References and Sources
Frequently Asked Questions (FAQs)
What should I expect during the procedure?
You will feel a small pinch from the local anesthesia, followed by minimal discomfort during the biopsy.
How long does the procedure take?
The procedure typically takes about 30 minutes to an hour.
Will I need to take time off work?
Most patients can return to normal activities within a day or two, but follow your doctor's advice.
