CPT Code 19081: Breast Biopsy with Imaging Guidance and Placement of Localization Device

What is breast biopsy with imaging and localization?

CPT code 19081 refers to a percutaneous breast biopsy procedure performed with stereotactic guidance or other imaging modalities, including the placement of a breast localization device such as a clip, metallic pellet, or marker. This procedure involves obtaining tissue samples from suspicious breast lesions visualized through mammography or tomosynthesis imaging guidance, allowing for accurate diagnosis and further treatment planning.

This procedure code includes imaging guidance, needle placement, biopsy specimen retrieval, and confirmation imaging to ensure the localization device is correctly placed at the lesion site. The localization device aids surgeons in identifying the lesion during surgery, especially when the lesion is non-palpable.

Commonly performed in outpatient radiology suites by qualified healthcare providers, CPT code 19081 is essential in diagnosing breast abnormalities and planning treatment. It can be applied to the same breast or bilateral procedures when indicated.

CPT code 19081 documentation requirements

Accurate documentation is critical for proper billing and compliance. Include the following:

• Indication for the biopsy and precise location of the breast lesion (e.g., left breast, right breast, or bilateral procedure).
• Type of imaging guidance used (e.g., stereotactic guidance, ultrasound guidance, or magnetic resonance guidance).
• Description of the biopsy technique, including needle type, number of passes, and whether a clip, metallic pellet, or wire localization device was placed.
• Confirmation images demonstrating placement of the localization device and imaging of the biopsy specimen.
• Documentation of any complications or difficulties during the procedure.
• Separate records for specimen handling, pathology submission, and assessment of specimen adequacy.
• Note if the procedure was performed by the same physician managing the patient’s care.

CPT code 19081 billing guidelines

• Report CPT code 19081 once for the percutaneous biopsy of the first lesion, including placement of the breast localization device and imaging of the biopsy specimen when performed.
• Use CPT code 19082 for each additional lesion biopsied in the same breast during the same session.
• Do not separately bill for the imaging guidance or the localization device; these are included in the primary procedure code.
• Modifier -LT or -RT should be appended to indicate the side of the procedure.
• For bilateral procedures, report 19081 with the appropriate modifiers.
• The code includes both technical and professional components; use modifiers -26 or -TC if billing components separately.
• Avoid reporting CPT 19081 on the same day as screening mammography codes like 77063 or diagnostic mammography (77065–77067) for the same breast.
• Ensure compliance with American Medical Association and Medicare Administrative Contractor (MAC) policies for medical billing and reimbursement.

Other relevant CPT codes

• 19082 – Each additional lesion, same breast
• 19083–19085 – Biopsies using ultrasound or MRI guidance
• 19281 – Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; first lesion, including mammographic guidance