Summary & Overview
CPT 19298: Image-Guided Brachytherapy Catheter Placement
CPT code 19298 denotes image-guided placement of multiple tube- and button-type brachytherapy catheters at a treatment site, commonly performed in association with breast-conserving surgery or as a separate procedure to deliver localized radiotherapy. Nationally, this code is relevant for facilities and clinicians managing postoperative or standalone brachytherapy workflows, impacting billing practices, procedural planning, and care coordination for patients requiring targeted radiation.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a consolidated view of coverage practices and payment benchmarks for these major payers, where available, and highlights clinical context relevant to surgical and radiation oncology teams.
Readers will learn the clinical indications and settings where CPT code 19298 is applied, how it integrates with partial mastectomy care pathways, common billing considerations, and where to look for payer-specific policy language. The piece also outlines typical service lines and sites of care, and notes where input data is not available.
Billing Code Overview
CPT code 19298 describes the placement of multiple tube- and button-type brachytherapy catheters at a treatment site for radiotherapy, performed after loading brachytherapy catheters. The provider uses image guidance to ensure correct placement. This procedure may occur during the same session as a partial mastectomy or at a later date.
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Service type: Image-guided brachytherapy catheter placement for radiation treatment
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Typical site of service: Ambulatory surgical center or hospital outpatient setting; may also occur in an operating room during a partial mastectomy session
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman diagnosed with early-stage breast cancer who undergoes breast-conserving surgery (partial mastectomy/lumpectomy) followed by localized high-dose-rate (HDR) brachytherapy. The procedure 19298 is performed when the radiation oncologist places multiple catheter tubes and surface button-type applicators into the lumpectomy cavity or surrounding breast tissue under image guidance (ultrasound or fluoroscopy) to facilitate subsequent fractionated radiotherapy. This may occur at the same operative session as the partial mastectomy or as a separate outpatient/interventional radiology procedure. Pre-procedure workflow includes multidisciplinary planning with the surgeon and radiation oncologist, imaging to identify the target volume, informed consent documenting risks/benefits and alternatives, anticoagulation review, and sterile preparation. During the procedure, the patient is positioned, local or general anesthesia is administered per surgeon/radiation oncologist preference, image guidance is used to confirm optimal catheter placement and depth, and catheter entry sites are secured with button-type anchors and dressings. Post-procedure workflow includes immediate imaging verification, documentation of number and type of catheters placed, pain management, discharge instructions for catheter care, scheduling of HDR brachytherapy fractions, and coordination for device removal when treatment is complete.
Coding Specifications
| Modifier | Description | When to Use |
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