Summary & Overview
CPT 19283: Stereotactic-Guided Breast Lesion Localization, First Lesion
CPT code 19283 denotes stereotactic-guided placement of a device for breast lesion localization and applies to the first lesion treated during an encounter. This procedure enables precise marking of nonpalpable breast lesions to guide subsequent biopsy or surgical excision, supporting timely cancer diagnosis and targeted treatment. Nationally, accurate coding for lesion localization affects clinical workflow, claims adjudication, and resource allocation in breast imaging and surgical services.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for use of 19283, common payer coverage considerations, typical sites of service, and relevant coding relationships. Benchmarks and policy updates are summarized where available; if specific payer policies or reimbursement benchmarks are not provided in the input, the text indicates that data is not available in the input.
This publication explains when 19283 is used (first lesion stereotactic localization), distinguishes typical service settings (outpatient radiology and breast imaging centers), and outlines topics readers can expect: coding guidance context, modifier and billing considerations, payer coverage patterns, and operational implications for radiology and surgical teams.
Billing Code Overview
CPT code 19283 describes a stereotactic-guided placement of a device for breast lesion localization. In this procedure, a provider places a localization device such as a clip, metallic pellet, wire/needle, or radioactive seed at the targeted breast lesion under stereotactic imaging guidance. Use of 19283 applies to the first lesion localized during the encounter.
Service Type: Image-guided breast lesion localization
Typical Site of Service: Outpatient radiology suite, breast imaging center, or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A 58-year-old woman with a mammographic target lesion identified on screening mammography is scheduled for a stereotactic breast localization procedure prior to a planned surgical excisional biopsy. Under local anesthesia in an imaging suite, a radiologist or breast surgeon uses stereotactic guidance to place a localization device (such as a clip, metallic pellet, wire/needle, or radioactive seed) into the targeted lesion to guide the surgeon to the exact site during subsequent operative resection. The workflow includes pre-procedure review of imaging, informed consent, stereotactic targeting with verification images, device placement, post-placement mammographic confirmation, and procedure documentation noting laterality, device type, number of lesions localized (this code billed for the first lesion), and any immediate complications. Typical site of service is an outpatient imaging center, hospital radiology department, or ambulatory surgical center.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing for the physician/radiologist interpretation component separate from technical imaging services. |
| 59 | Distinct procedural service | When this localization is distinct from other procedures on the same date (e.g., separate biopsy or surgical procedure) and no other modifier applies.
| | Repeat procedure by same physician | (Not in provided list) Data not available in the input.