CPT code 19284 is for the placement of a breast localization device, such as a clip, during a surgical procedure.
CPT code 19284 is used to describe the procedure of placing a percutaneous device in the breast for the purpose of adding structural support. This code is typically used in the context of breast surgeries where additional support is needed, such as in reconstructive procedures following a mastectomy. The term "percutaneous" refers to the method of accessing the breast tissue through the skin, rather than through a more invasive surgical approach.
When using CPT code 19284, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the work required to perform the procedure is substantially greater than typically required.
2. Modifier 50 - Bilateral Procedure: This modifier is used if the procedure is performed on both breasts during the same session.
3. Modifier 51 - Multiple Procedures: Apply this modifier if multiple procedures are performed during the same surgical session.
4. Modifier 52 - Reduced Services: Use this modifier if the procedure is partially reduced or eliminated at the physician's discretion.
5. Modifier 59 - Distinct Procedural Service: This modifier is used to indicate that a procedure or service was distinct or independent from other services performed on the same day.
6. Modifier 76 - Repeat Procedure by Same Physician: Use this modifier if the same procedure is repeated by the same physician.
7. Modifier 77 - Repeat Procedure by Another Physician: Apply this modifier if the same procedure is repeated by a different physician.
8. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
9. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period.
10. Modifier LT - Left Side: This modifier is used to specify that the procedure was performed on the left breast.
11. Modifier RT - Right Side: This modifier is used to specify that the procedure was performed on the right breast.
12. Modifier 99 - Multiple Modifiers: Use this modifier if more than four modifiers are necessary to describe the service.
These modifiers help provide additional information about the procedure and ensure accurate billing and reimbursement. Always verify the specific payer requirements and guidelines when applying modifiers.
The CPT code 19284 is reimbursed by Medicare, but it is essential to verify the specifics through the Medicare Physician Fee Schedule (MPFS) and your regional Medicare Administrative Contractor (MAC). The MPFS provides detailed information on the reimbursement rates for various CPT codes, including 19284. Additionally, MACs may have specific guidelines or requirements that could affect reimbursement. Therefore, it is advisable to consult both the MPFS and your MAC to ensure accurate and up-to-date information regarding the reimbursement of CPT code 19284.
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