Summary & Overview
CPT 19284: Stereotactic Breast Localization, Additional Lesion
CPT code 19284 designates an add-on stereotactic breast localization procedure for placement of a secondary localization device (such as a clip, metallic pellet, wire/needle, or radioactive seed) at an additional lesion during the same session as an initial localization. As an add-on code, 19284 is billed in conjunction with the primary localization service and is relevant to breast imaging, surgical planning, and oncologic workflows. Nationally, accurate coding for add-on localization supports appropriate tracking of procedure complexity and resource use in breast-conserving therapy pathways.
Key payers included in this nationwide review are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The summary outlines payer coverage patterns, common modifiers and billing considerations, and where 19284 fits within breast localization coding practice.
Readers will learn the clinical context for using 19284, the typical sites of service and procedural setting, and the coding relationship between the primary stereotactic localization and this add-on entry. The publication also provides benchmarks and policy-focused context relevant to reimbursement and documentation expectations. Data not available in the input is noted where specific payer policy details, associated taxonomies, ICD-10 pairings, and related codes would otherwise be required.
Billing Code Overview
CPT code 19284 is an add-on stereotactic breast localization procedure used when a provider places a localization device (for example, a clip, metallic pellet, wire/needle, or radioactive seed) at an additional breast lesion during the same session that another localization device is placed at an initial lesion. This code represents an extra localization placement performed under stereotactic guidance.
Service type: Image-guided breast lesion localization (add-on)
Typical site of service: Outpatient imaging suite, breast imaging center, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 58-year-old female with a screening mammogram showing a suspicious calcification cluster in the right breast is scheduled for stereotactic localization and subsequent surgical excisional biopsy. During the stereotactic session the radiologist places a localization device (for example, a metallic clip) at the target lesion. In the same procedure the radiologist identifies an additional small suspicious area in the same breast and places a second localization device at that additional lesion during the same stereotactic session; the second placement is reported with add-on code 19284 to indicate localization of an additional lesion.
The clinical workflow: pre-procedure consent and review of imaging; stereotactic breast positioning and core or marker placement at the initial lesion (primary code, billed separately); intra-procedural imaging to confirm placement; identification of the additional lesion on the same stereotactic session; placement of the additional localization device documented as an add-on service; post-procedure imaging to document positions; procedural note specifying devices placed, laterality, and that placements occurred at the same session. Typical preauthorization and bundling rules are checked based on payer policies prior to billing.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
50 | Bilateral procedure |