CPT code 19081 is a procedure code for a breast biopsy of the first lesion using stereotactic guidance.
CPT code 19081 is used to describe a procedure where a biopsy is taken from the first lesion in the breast using stereotactic guidance. This means that imaging technology is used to precisely locate the lesion and guide the needle to the correct spot for tissue sampling. This code is specifically for the initial lesion being biopsied.
For CPT code 19081, the following modifiers may be applicable:
1. Modifier 50 (Bilateral Procedure): Used when the procedure is performed on both breasts during the same session.
2. Modifier 51 (Multiple Procedures): Applied when multiple procedures are performed during the same surgical session.
3. Modifier 52 (Reduced Services): Used when the procedure is partially reduced or eliminated at the physician's discretion.
4. Modifier 59 (Distinct Procedural Service): Indicates that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 76 (Repeat Procedure by Same Physician): Used when the same procedure is repeated by the same physician on the same day.
6. Modifier 77 (Repeat Procedure by Another Physician): Applied when the same procedure is repeated by a different physician on the same day.
7. Modifier 78 (Unplanned Return to the Operating/Procedure Room): Used when a related procedure is performed during the postoperative period of the initial procedure.
8. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): Indicates that an unrelated procedure was performed by the same physician during the postoperative period of the initial procedure.
9. Modifier 91 (Repeat Clinical Diagnostic Laboratory Test): Used when the same laboratory test is repeated on the same day to obtain subsequent (multiple) test results.
10. Modifier LT (Left Side): Indicates that the procedure was performed on the left breast.
11. Modifier RT (Right Side): Indicates that the procedure was performed on the right breast.
Each of these modifiers serves a specific purpose and should be used appropriately to ensure accurate billing and reimbursement.
The CPT code 19081, which is used for a specific medical procedure, is reimbursed by Medicare. To determine the reimbursement rate, healthcare providers should refer to the Medicare Physician Fee Schedule (MPFS). The MPFS provides detailed information on the payment rates for various CPT codes, including 19081. Additionally, it is essential to consult with your local Medicare Administrative Contractor (MAC) as they are responsible for processing Medicare claims and can provide specific guidance on coverage and reimbursement policies for CPT code 19081.
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