Placement of breast localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous; each additional lesion, including ultrasound guidance (List separately in addition to code for primary procedure)
CPT4 code
Name of the Procedure:
Placement of Breast Localization Device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), Percutaneous; Each Additional Lesion, Including Ultrasound Guidance
Summary
This procedure involves placing a localization device, such as a clip, wire, or radioactive seed, into the breast to mark specific areas for further examination or treatment. Ultrasound guidance ensures accurate placement of the device.
Purpose
The procedure is primarily done to mark lesions or abnormalities in the breast for further diagnostic tests or surgical procedures. It helps in precisely locating the lesion during surgery or biopsy.
Indications
- Suspicious mammogram or ultrasound findings.
- Palpable lumps in the breast.
- Abnormal breast tissue requiring further investigation.
- Pre-surgical marking for lesion excision.
Preparation
- Follow fasting guidelines if sedation or anesthesia is required.
- Avoid using lotions or deodorants on the breast area.
- Complete necessary pre-procedure diagnostic imaging (e.g., mammogram, ultrasound).
- Inform the healthcare provider of any medications, especially blood thinners.
Procedure Description
- The patient lies on an examination table, and the breast area is exposed.
- The area of interest is identified using ultrasound imaging.
- Local anesthesia is administered to numb the area.
- A small incision may be made, and the localization device (clip, wire, or radioactive seed) is inserted percutaneously (through the skin) into the breast tissue.
- The device is positioned accurately within or near the lesion under continuous ultrasound guidance.
- For additional lesions, the same steps are repeated.
- The insertion site may be covered with a small bandage.
Duration
The procedure typically takes about 30 minutes to 1 hour, depending on the number of lesions being localized.
Setting
The procedure is usually performed in a hospital radiology department or an outpatient imaging clinic.
Personnel
- Radiologist or breast surgeon
- Radiology technologist
- Nurse
Risks and Complications
Common risks:
- Bruising or minor bleeding at the insertion site.
- Temporary pain or discomfort. Rare risks:
- Infection at the insertion site.
- Misplacement of the localization device.
Benefits
- Precise localization of breast lesions enhances the accuracy of biopsies or surgeries.
- Minimally invasive with a short recovery time.
- Helps in complete and safe removal of abnormalities during surgery.
Recovery
- Patients can usually resume normal activities shortly after the procedure.
- Keep the insertion site clean and dry.
- Monitor for signs of infection (redness, swelling, fever).
- Follow-up imaging or appointment may be scheduled.
Alternatives
- Stereotactic-guided biopsy or wire localization.
- MRI-guided localization.
- Pros and cons vary, but percutaneous placement with ultrasound guidance is typically less invasive with accurate results.
Patient Experience
- Slight discomfort or pressure might be felt during the insertion.
- Post-procedure soreness at the site is common but usually mild.
- Over-the-counter pain relievers can help manage discomfort.
- Ultrasound makes the procedure more comfortable and precise.