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.
| 76 | Repeat procedure by same physician | (Not in provided list) Data not available in the input.
| 52 | Reduced services | When the procedure is partially reduced or not completed as described.
| 53 | Discontinued procedure | When the procedure is terminated due to extenuating circumstances or patient condition.
| 25 | Significant, separately identifiable evaluation and management service | When an E/M visit on the same day is significant and separately documented.
| 59 | Distinct procedural service | Duplicate entry avoided; see first 59 row.
| LT | Left side | When the procedure is performed on the left breast.
| RT | Right side | When the procedure is performed on the right breast.
| TC | Technical component | When billing only the technical component (imaging equipment and technologist) separate from the professional component.
| AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | When an advanced practice clinician assists, if applicable per payer rules.
| QK | Medical direction of two, three, or four concurrent anesthesia procedures | (Limited relevance) Use only when anesthesia direction requirements apply.
| XU | Unusual non-overlapping service by same physician | When documentation supports that the services are distinct and separate.
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RH0000X | Radiology - Diagnostic Radiology | Radiologists commonly perform stereotactic localization in imaging suites. |
| 207XS0112X | Surgery - Breast Surgery | Breast surgeons may perform localization procedures, particularly intraoperative seed placement or wire localization.
| 363A00000X | Nurse Practitioner | NPs in breast imaging clinics may assist in coordination and periprocedural care.
| 207LP2900X | Radiology - Interventional Radiology | Interventional radiologists may be involved when localization requires image-guided techniques.
| 208000000X | Surgery - General Surgery | General surgeons involved in breast procedures may perform or coordinate localization placement.
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N63 | Unspecified lump in breast | Common indication for localization when a palpable or imaging-detected lump requires targeted surgical excision. |
| R92.8 | Other abnormal and inconclusive findings on diagnostic imaging of breast | Used for lesions detected on imaging that need localization prior to excision.
| R92.1 | Other abnormal and inconclusive mammogram | Indicates abnormal mammographic findings prompting localization for planned biopsy or excision.
| D24.9 | Benign neoplasm of breast, unspecified | Benign-appearing lesions may still be localized for definitive excision.
| C50.919 | Malignant neoplasm of unspecified site of right female breast | Malignancy diagnosis when localization is part of surgical planning for tumor resection.
| C50.912 | Malignant neoplasm of left female breast, unspecified site | Same clinical relevance for left-sided breast cancer localization.
| N64.4 | Mastitis, unspecified | Inflammatory lesions or complex infections may occasionally require localization for drainage or excision when focal collection is present.
| R92.2 | Inconclusive mammogram, unspecified | Used when mammographic findings are indeterminate and localization is planned for diagnostic excision.
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
19081 | Biopsy, breast, with placement of breast localization device(s), imaging supervision and interpretation; first lesion, stereotactic guidance | A stereotactic core needle biopsy with localization may be performed at the same session; 19081 represents biopsy plus device placement when both are performed. |
| 19282 | Placement of radiopaque localization marker (eg, clip) percutaneous, any modality; for second and subsequent lesion(s) | Used when additional lesions beyond the first require localization; 19283 is billed for the first lesion.
| 19295 | Injection for radioactive seed localization (percutaneous) | Radioactive seed localization procedures may be coded with seed-specific codes depending on payer rules and whether separate coding is required.
| 77012 | Computed tomography guidance for placement of localization device | When CT guidance is used instead of stereotactic mammography, imaging guidance codes such as 77012 may be relevant.
| 76000 | Fluoroscopic guidance for localization of lesion, initial localization | Fluoroscopic imaging guidance codes apply if fluoroscopy is used during localization instead of stereotactic techniques.
| 88305 | Surgical pathology, gross and microscopic examination | Pathology code commonly billed after excision of a localized lesion for diagnostic evaluation.