Summary & Overview
CPT 19286: Ultrasound-Guided Breast Localization, Add-On
CPT code 19286 describes an add-on ultrasound-guided breast localization procedure in which a provider places a localization device (clip, metallic pellet, wire/needle, or radioactive seed) during the same session as placement of another device at an initial lesion. This code captures an increasingly common imaging-assisted localization step used to guide subsequent diagnostic or surgical interventions, and it matters nationally as breast-conserving workflows and image-guided procedures continue to expand.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find context on the clinical purpose of the code, typical sites of service where it is performed, and the service type it represents. The publication outlines billing considerations tied to it, common modifiers associated with the code, and how the code relates to procedural workflows.
The analysis provides benchmarks and policy-oriented context useful to billing managers, radiologists, breast surgeons, and revenue cycle staff. It highlights the role of ultrasound guidance in localization, the typical clinical scenarios when localization is placed at the same session as another device, and what aspects of coding and billing merit attention. Data not available in the input are noted explicitly where applicable.
Billing Code Overview
CPT code 19286 is an add-on breast localization procedure performed with ultrasound guidance. In this service, the provider places a localization device — such as a clip, metallic pellet, wire/needle, or radioactive seeds — at the time of placing another device at an initial lesion.
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Service type: Image-guided breast localization (ultrasound-guided placement of a localization device)
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Typical site of service: Outpatient imaging suite, breast clinic, or ambulatory surgical center where ultrasound guidance and minor localization procedures are performed.
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Clinical & Coding Specifications
Clinical Context
A typical patient is a woman with a suspicious breast lesion identified on diagnostic imaging (mammography or ultrasound) or clinical exam and scheduled for image‑guided localization prior to surgical excision or stereotactic biopsy. In the radiology suite, under ultrasound guidance, the interventional radiologist or breast surgeon places a localization device (for example, a clip, metallic seed, radioactive seed, or wire) into the lesion during the same session that another localization or device was placed at an initial lesion. The workflow commonly includes pre‑procedure consent and review of prior imaging, ultrasound localization with sterile technique, placement of the device confirmed with ultrasound (and often mammographic or specimen radiograph confirmation), documentation of laterality and marker type, and communication of marker position to the surgical team. Typical site of service is the outpatient radiology or breast imaging department; inpatient placement can occur when coordinated with surgical service. Typical patient scenario: a 62‑year‑old woman with a new 8 mm hypoechoic mass on diagnostic ultrasound scheduled for preoperative seed localization; the operator places a second localization device in a nearby lesion during the same session and codes the additional placement as the add‑on procedure 19286.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |