Summary & Overview
HCPCS C7502: MR-Guided Percutaneous Breast Biopsy with Localization
HCPCS Level II code C7502 denotes magnetic resonance-guided percutaneous breast biopsy with placement of a localization device (e.g., clip or metallic pellet) and imaging of the biopsy specimen when performed. This procedure is an advanced, image‑guided diagnostic intervention used for lesions best visualized with MR, supporting accurate tissue sampling and subsequent surgical planning. Nationally, MR‑guided breast biopsy plays a role in diagnostic pathways for patients with indeterminate or occult lesions on mammography or ultrasound, and its classification under HCPCS Level II ensures standardized reporting for facility and payer processing.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will gain a concise understanding of the clinical service and sites of care associated with C7502, common billing modifiers and procedural context, and what to expect in claims submission and coverage evaluation. The publication provides benchmarks and policy context relevant to facility and payer reimbursement, outlines coding nuances for unilateral versus bilateral procedures, and summarizes typical documentation elements tied to MR‑guided biopsy services. Data not available in the input is noted where necessary.
Billing Code Overview
HCPCS Level II code C7502 describes percutaneous breast biopsy using magnetic resonance (MR) guidance, including placement of a breast localization device (for example, a clip or metallic pellet), when performed, and imaging of the biopsy specimen, when performed. The code applies to procedures performed on one or both breasts; for a single lesion biopsy, use the appropriate single-lesion code.
Service Type: **Image-guided interventional breast procedure (MR-guided percutaneous biopsy)"
Typical Site of Service: Hospital outpatient imaging or interventional radiology suite, outpatient specialty imaging center, or ambulatory surgical center
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman with a suspicious enhancing lesion seen only on diagnostic breast MRI is scheduled for a percutaneous MRI-guided breast biopsy with marker placement. She underwent pre-procedure history and consent in the breast imaging clinic, screening for MRI contraindications (eg, pacemaker, metallic foreign bodies), and an IV was placed for contrast if re-imaging is required. In the MRI suite the patient is positioned prone on an MRI breast coil; targeted sequences localize the lesion. Under MRI guidance, a radiologist advances a biopsy device percutaneously into the lesion, obtains core samples, and places a metallic clip or pellet to mark the biopsy site. Specimen imaging (radiograph or MRI) is performed when the lesion is known or suspected to contain calcifications or to confirm retrieval of marker-containing tissue. Hemostasis is achieved and the patient is observed briefly before discharge with wound care instructions and follow-up arranged for pathology results and possible surgical consultation if malignancy is identified.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | When work required is substantially greater than typical (document justification). |
51 |