CPT code 19082 is for a breast biopsy of an additional lesion using stereotactic guidance.
CPT code 19082 is used to describe the procedure of performing a biopsy on an additional lesion in the breast using stereotactic guidance. This code is specifically for the biopsy of a second or subsequent lesion, following the initial biopsy procedure. Stereotactic guidance involves using a three-dimensional coordinate system to locate the precise area of the breast tissue that needs to be sampled, ensuring accuracy and minimizing damage to surrounding tissues.
For CPT code 19082, the following modifiers may be applicable:
1. Modifier 26 - Professional Component: Used when only the professional component of the service is being billed, such as the interpretation of the results.
2. Modifier TC - Technical Component: Used when only the technical component of the service is being billed, such as the use of equipment and supplies.
3. Modifier 50 - Bilateral Procedure: Used when the procedure is performed on both breasts during the same session.
4. Modifier 51 - Multiple Procedures: Used when multiple procedures are performed during the same session.
5. Modifier 52 - Reduced Services: Used when the service provided is less than what is usually required.
6. Modifier 53 - Discontinued Procedure: Used when the procedure is started but discontinued due to extenuating circumstances or those that threaten the well-being of the patient.
7. Modifier 59 - Distinct Procedural Service: Used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
8. Modifier 76 - Repeat Procedure by Same Physician: Used when the same procedure is repeated by the same physician.
9. Modifier 77 - Repeat Procedure by Another Physician: Used when the same procedure is repeated by a different physician.
10. Modifier 78 - Unplanned Return to the Operating/Procedure Room: Used when a related procedure is performed during the postoperative period.
11. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Used when an unrelated procedure is performed by the same physician during the postoperative period.
12. 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.
These modifiers help provide additional information about the circumstances under which the procedure was performed, ensuring accurate billing and reimbursement.
When considering whether CPT code 19082 is reimbursed by Medicare, it is essential to consult the Medicare Physician Fee Schedule (MPFS) and the guidelines provided by your regional Medicare Administrative Contractor (MAC). The MPFS is a comprehensive listing of the payment rates used by Medicare to reimburse physicians and other healthcare providers for services rendered. Each MAC may have specific local coverage determinations (LCDs) that can affect reimbursement.
For CPT code 19082, you would need to verify its inclusion and the associated reimbursement rate within the MPFS. Additionally, checking with your MAC is crucial, as they can provide specific guidance on whether this code is covered and any particular documentation or medical necessity requirements that must be met for reimbursement.
In summary, to determine if CPT code 19082 is reimbursed by Medicare, you should review the MPFS and consult your regional MAC for any specific coverage details and requirements.
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