Radiology Coding Alert

Confirm the imaging guidance and keep a count on lesions.

Accurately coding breast procedures in 2014 will require you to confirm the type of guidance your radiologist used when placing a localization device and to count each additional lesion. Read on for more instruction on the new codes and deletions for breast localization services.

Brush Up on Image Guidance

Having a handle on the types of imaging guidance used is a good first step to choosing the correct localization device code next year. Kelly C. Loya, CPC-I, CHC, CPhT, CRMA, Director of Reimbursement and Advisory Services, Altegra Health, Inc, shares a general explanation of each of these guidance techniques:

• Mammographic guidance: using radiation/X-ray image of breast tissue to verify the placement of the localization device near the targeted tissue.
• Stereotactic guidance: a special mammography machine using X-rays to help guide the provider’s instruments to the site of the abnormal growth.
• Ultrasound guidance: high frequency sound waves (ultrasound) are sent and received by a machine, creating an image used to guide needle placement.
• Magnetic resonance guidance: use of powerful magnetic fields and radiofrequency pulses to create detailed images.

Count Each Additional Lesion

For an overview of the new CPT® codes describing the localization, number of lesions treated and guidance used, see the table below, provided by Loya:

Keep in mind: CPT® codes +19282, +19284, +19286 and +19288 are add-on codes and will only be reported in addition to the primary procedure code.

Editor’s note: Look for more updates on the 2014 breast localization procedure coding changes and other 2014 topics in future issues of Radiology Coding Alert. q