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#BREAST LUMPECTOMY WITH SENTINEL NODE BIOPSY CPT CODE CODE#

For paper claim submission, include a detailed description of the service performed in Box 80.For electronic claim submission, include a detailed description of the service performed in the SV202-7.

For paper claim submission, include a detailed description of the service performed in Box 19.

For electronic claim submission, include a detailed description of the service performed in the SV101-7 or the 2400 service line loop.

Providers submitting unlisted codes must submit the following Note: Providers should only bill 19499 for breast biopsies performed using only tomosynthesis imaging guidance. If the combination stereotactic–tomosynthesis guided biopsy is performed using a standard digital breast tomosynthesis mammography unit on which the post-procedure mammogram is also obtained, it is not appropriate to report the post-procedure mammogram separately.” If a combination stereotactic–tomosynthesis guided biopsy is performed using a separate piece of equipment (such as a prone table) and the patient is moved to another unit for a post-procedure mammogram, it is appropriate to report the post-procedure mammogram separately.

#BREAST LUMPECTOMY WITH SENTINEL NODE BIOPSY CPT CODE CODE#

“When a breast biopsy is performed using both stereotactic and tomosynthesis imaging guidance, it is appropriate to use CPT code 19081, Biopsy, breast, with placement of breast localization device(s) (e.g., clip, metallic pellet), when performed, and imaging of the biopsy specimen, when performed, percutaneous first lesion, including stereotactic guidance. The American Medical Association (AMA)/ American College of Radiology (ACR) Clinical Examples in Radiology Fall 2016 issue, provides guidance on the reporting of both a stereotactic and tomosynthesis imaging-guided core breast biopsy as follows: Review of medical records identified 19499 was being used for breast biopsies performed with stereotactic and tomosynthesis image guidance. Coding & Billing Guidelinesīlue Cross Blue Shield of North Dakota (BCBSND) has identified an increase in providers billing CPT 19499, Unlisted Procedure, Breast.

This document provides coding and billing guidelines for breast biopsies.