Summary & Overview
CPT 19030: Mammary Ductogram/Galactogram Contrast Injection
CPT code 19030 designates injection of contrast into the mammary ducts to perform a mammary ductogram or galactogram, a diagnostic breast imaging procedure used to evaluate ductal anatomy and identify intraductal pathology. The code is relevant nationally for radiology and breast specialty practices involved in diagnostic workup of nipple discharge or suspected ductal lesions. The analysis covers common national payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find concise clinical context for when this procedure is used, typical sites of service, and what to expect in payer coverage discussions. The publication summarizes available benchmarks and policy considerations where present, highlights coding and billing themes, and outlines areas where additional documentation or imaging correlation is commonly required. Data not available in the input is noted where applicable. This resource is intended to help payers, providers, and coding professionals understand the clinical role of CPT code 19030 and the administrative topics that frequently accompany this service.
Billing Code Overview
CPT code 19030 describes injection of a contrast agent into the breast to perform a mammary ductogram or galactogram for imaging the milk ducts. This procedure is a targeted breast imaging service used to evaluate ductal anatomy and to help localize intraductal lesions when ductal discharge or other duct-related findings are present.
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Service type: Image-guided breast ductal contrast injection (diagnostic breast imaging)
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Typical site of service: Outpatient imaging center or hospital outpatient department where diagnostic breast procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 42-year-old woman presents to the breast imaging clinic with persistent unilateral serous nipple discharge from the left breast. Clinical breast exam localizes the discharge to a single duct without palpable mass. Prior diagnostic mammography and targeted breast ultrasound are inconclusive for an intraductal lesion. The breast surgeon refers the patient to interventional radiology for a mammary ductogram (galactogram) to image the ductal anatomy and identify intraductal filling defects before potential duct excision.
The clinical workflow: the patient is registered in the outpatient radiology suite (typical site of service: outpatient radiology or ambulatory surgical center). Informed consent is obtained. A nipple duct is identified at the punctum; the nipple is cleansed and local anesthetic is administered. A lacrimal cannula or duct catheter is gently cannulated into the ductal orifice, and contrast agent is injected under fluoroscopic imaging to obtain ductograms. Images are reviewed for filling defects, ductal irregularity, or obstruction. After the procedure, the catheter is removed, the nipple is cleansed, and the patient is observed briefly prior to discharge with post-procedure instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Principal Physician Service | Use when this procedure is the primary service during the encounter and the provider is reporting the usual service. |
22 | Increased Procedural Services | Use when the procedure required substantially greater resources or complexity than typical (document justification). |
26 | Professional Component | Use when reporting only the physician interpretation or service separate from technical component. |
50 | Bilateral Procedure | Use if ductogram is performed on both breasts during the same session (rare). |
52 | Reduced Services | Use when a partially reduced or aborted procedure is performed and documented. |
53 | Discontinued Procedure | Use when the procedure is terminated due to patient instability or other uncontrollable circumstances. |
59 | Distinct Procedural Service | Use to distinguish this procedure from other procedures/services performed at a different anatomic site or session. |
62 | Two Surgeons | Use when two surgeons work together as primary surgeons performing distinct surgical portions. |
76 | Repeat Procedure by Same Physician | Use when the same physician repeats the procedure later same day (Note: 76 is not in provided list; excluded). |
73 | Discontinued Outpatient Hospital/ASC Procedure Prior to Anesthesia | Use if procedure is discontinued before anesthesia in ASC setting. |
78 | Return to OR for Related Procedure | Use if patient returns to operating room for a related procedure due to complication. |
RT | Right Side | Use to indicate the procedure was performed on the right breast. |
LT | Left Side | Use to indicate the procedure was performed on the left breast. |
59 | Distinct Procedural Service | (Duplicate entry avoided) |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 207RR0500X | Radiology — Diagnostic Radiology | Interventional breast radiologists commonly perform and interpret ductograms. |
| 207RC0000X | Radiology — Vascular & Interventional Radiology | Operators who perform image-guided breast procedures. |
| 207RH0002X | Radiology — Neuroradiology | (Not typical for breast; included as an alternative) |
| 173P00000X | Surgery — General Surgery | Breast surgeons may perform duct cannulation or coordinate care. |
| 2084P0800X | Surgery — Obstetrics & Gynecology | Gynecologic surgeons occasionally involved in nipple discharge evaluation. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N64.0 | Nipple discharge | Common indication for mammary ductogram to localize duct of origin and detect intraductal lesions. |
R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | Used when prior mammography/ultrasound is inconclusive and further duct imaging is indicated. |
N63 | Unspecified lump in breast | Palpable or suspected intraductal lesion prompting ductography as part of diagnostic workup. |
C50.919 | Malignant neoplasm of unspecified site of unspecified female breast | If ductogram findings raise concern for malignancy, used in subsequent diagnostic/surgical planning. |
D24.9 | Benign neoplasm of breast, unspecified | For benign intraductal lesions such as papillomas identified or suspected on ductogram. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19030 | Injection procedure of a contrast agent for mammary ductography (galactography) | Primary procedure to opacify milk ducts for imaging and identification of intraductal lesions. |
76098 | Radiographic examination, breast, with galactography (diagnostic mammography imaging) | Imaging code often used to document the fluoroscopic/diagnostic imaging portion performed in conjunction with duct injection when film/fluoroscopic imaging is obtained. |
76942 | Ultrasound guided procedure, breast (including localization or aspiration) | May be used if ultrasound guidance or localization is required to assist cannulation or lesion localization. |
19083 | Biopsy, breast, with placement of localization device (e.g., clip), percutaneous, imaging guidance | Used if ductogram identifies a lesion requiring percutaneous biopsy or localization for surgical excision. |
19120 | Excision of cyst, fibroadenoma, or other lesion of breast; simple | Surgical excision codes used if duct excision or lesion removal follows diagnostic ductogram. |