Summary & Overview
CPT 19288: MRI-Guided Add-On Breast Localization
CPT code 19288 denotes an add-on magnetic resonance image (MRI) guidance procedure used to place an additional localization device for breast lesions — for example, a clip, metallic pellet, wire/needle, or radioactive seed — when placed during the same session as an initial device. As an add-on code, it is reported in conjunction with a primary breast localization or image-guided procedure and is relevant for facilities and radiology or breast surgery providers who perform image-guided interventions.
This publication addresses national reimbursement and operational context across major payers including Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of how the service is defined clinically, typical sites of service, and what to expect in claims submissions for an add-on MRI-guided localization. The report summarizes payer coverage trends, common billing modifiers observed in practice, and considerations for coding when multiple localization devices are placed in one session.
The briefing provides actionable benchmarking and policy context: it explains clinical indications for MRI-guided localization, how the add-on nature of 19288 affects reporting, typical settings where the procedure is performed, and areas where payer policies or documentation requirements commonly vary. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 19288 is an add-on magnetic resonance image (MRI) guidance procedure used to place an additional localization device for breast lesions. The procedure involves using MRI guidance to place devices such as a clip, metallic pellet, wire/needle, or radioactive seed when an additional localization is required at the same session that another device is placed at an initial lesion.
Service type: Image-guided breast localization (add-on MRI-guided localization)
Typical site of service: Outpatient imaging suite or hospital outpatient department
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult woman with a known breast lesion undergoing image-guided localization prior to surgical excision. She has multiple foci or a second lesion identified on preoperative breast magnetic resonance imaging (MRI) in the same session as an initial localization. Under MRI guidance, the breast radiologist or breast surgeon places an additional localization device (for example, a clip, metallic pellet, wire/needle, or radioactive seed) at the second lesion during the same encounter when another localization device is placed at the initial lesion. The workflow includes pre-procedure review of prior imaging and indications, informed consent, MRI localization with sterile technique in the interventional MRI suite, placement and documentation of device position with confirmatory MRI images, post-procedure site care instructions, and coordination of the localization information with the surgical team for operative planning. Typical site of service is the hospital outpatient imaging department or an ambulatory surgery center with MRI-guided interventional capability.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Normal or routine service | When the procedure represents the usual service by the primary surgeon or reporting clinician. |
22 |