# needle localization wire - non breast



## JDACPC (Nov 17, 2010)

Report states:

_With CT guidance, an 8 cm mammographic localization wire was positioned with its
tip just deep to the node and the thickened reinforced part of the wire within the
node itself._

19290 specifically states breast.  Any references for this or an idea of an unlisted code?

Thank you!


----------



## preserene (Nov 17, 2010)

Was it for identification of the node or for therapy point of view. Was it an axillary node?
As you said both the needle and metallic clip localization are for breast.

So,with the info we got now, can you try for  the code- *38792*- which is injection procedure for identification of sentinel Node. for imaging  you could go for the *78195* lymphatic and lumph node imaging


----------



## JDACPC (Nov 18, 2010)

It's an enlarged axillary node but not for sentinal identification.  Pt had a bx previously but samples were nondiagnostic.


----------



## preserene (Nov 18, 2010)

Enlarged axillary node, previous(recent Hx of breast biopsy) with undetermined report, all that goes for a suspected node and all the  more do not know what lays there in the breast.
What was the purpose/intention of placing the wire or the diagnosis from the document. Check whether 77012 alone would do?
Was it correlated with yet another repeat biopsy of the Breast?
Can you give the whole documented report to get better. If not, I feel that you have to query your physician  whether it can be placed as an mandatory test for Biopsy breast


----------



## preserene (Nov 18, 2010)

Having said that I had been thinking of the real urging medical necessity for the procedure for the physician to accomplish; medical necessity in the sense that with the scenario given forth,  I wonder why the lesion in the axillary node with all its suspesion can not be correlated with Breast lesion  and consider the axillary node lesion as one related to breast lesion. *May be it is an axillary tail of the breast components !!??*
If I make some sense in this, when a lesion can be preoperatively marked by placing thin wire (radiologic marker) down to the lesion (19290), the lesion in the axillary region be it lymph draining that area of the breast, or the tail of the axillary region of breast tissues, we can CODE IT AS  19290, for any of these lesions. 
Also I would like to say that the breast tissues components are: the four quadrants , areola and nipple area, and the axillary tail of the breast.
Having that in mind the code 19290 can be thoughtfully appropriated for the wiring of the axillary region mass, be it lymph tissues/lymphatics draining the  axillary tail and the upper quadrant preoperatively, once the doctor feels or finds the medical necessity for that. WHY NOT? Hi, it is only a suggestion.
Discuss with your physician; you would come to the answer for this real challenge. 
Thank you for listening!


----------



## Grintwig (Nov 19, 2010)

Was a biopsy performed this time? 
Without any more information I would suggest the unlisted code 38999.


----------



## mckennak33 (Jan 21, 2016)

*CT Guided wire localization for GGO in the lung*

Need to find a code for CT Guided wire localization of lung mass prior to the surgeon performing the VATS wedge resection of the wired mass.  I have found codes for breast wire localization but not for the lung.  The radiology dept said they would code the wire placement using the 77012.  Is this the appropriate code to use.


----------



## akila.p (Feb 1, 2016)

*10035*

In 2016 we have a new codes like
 10035- Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle,
radioactive seeds), Percutaneous, including imaging guidance; first lesion
+10036 ; each additional lesion (List separately in addition to code for primary procedure).

my suggestion is 10035.


----------

