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Placement of soft tissue localization device(s) (eg, clip, metallic pellet, wire/needle, radioactive seeds), percutaneous, including imaging guidance; each additional lesion (List separately in addition to code for primary procedure)

CPT4 code

Name of the Procedure:

Placement of Soft Tissue Localization Device(s) (e.g., clip, metallic pellet, wire/needle, radioactive seeds), Percutaneous, Including Imaging Guidance; Each Additional Lesion

Summary

This procedure involves the placement of small localization devices into soft tissue using a needle under imaging guidance. The devices help to mark specific areas within the tissue for future reference, such as in surgery or radiation therapy.

Purpose

The procedure is utilized to precisely locate and mark lesions or areas of interest within soft tissue. It helps in guiding surgical removal, biopsy, or targeted therapy.

Indications

  • Suspicious lesions that need to be marked for biopsy or surgery
  • Localization for radiotherapy planning
  • Patients with tumors or abnormal tissue requiring accurate identification for treatment

Preparation

  • Patients may need to fast for a few hours before the procedure.
  • Certain medications might need to be paused or adjusted.
  • A preliminary imaging test (e.g., ultrasound, MRI, or mammogram) may be required to locate the lesion.

Procedure Description

  1. The patient is positioned comfortably based on the target area's location.
  2. Imaging guidance (ultrasound, mammography, or CT scan) is used to pinpoint the lesion.
  3. A local anesthetic is applied to numb the area.
  4. A needle is inserted through the skin to the targeted lesion.
  5. The localization device (clip, wire, metallic pellet, or radioactive seed) is placed through the needle into the lesion.
  6. The needle is withdrawn, leaving the device in place.
  7. Imaging may be repeated to confirm the correct placement of the device.

Duration

The procedure usually takes about 30 minutes to an hour, depending on the number of lesions and their locations.

Setting

It is typically performed in a hospital, outpatient clinic, or specialized radiology center.

Personnel

  • Radiologist or interventional radiologist
  • Radiology technician
  • Nursing staff

Risks and Complications

  • Minor bleeding or bruising at the insertion site
  • Infection
  • Discomfort or pain
  • Rarely, migration of the localization device

Benefits

  • Precise localization of lesions enhances the accuracy of surgical removal or targeted therapy.
  • Reduced risk of missing or misidentifying the lesion during subsequent procedures.

Recovery

  • Patients can usually return to normal activities shortly after the procedure.
  • Keep the insertion site clean and dry.
  • Follow-up images or appointments may be necessary to monitor the device.

Alternatives

  • Non-percutaneous marking techniques (e.g., tattooing skin surface, surgical marking during biopsy).
  • Imaging-guided surgery without prior localization.

    Pros and cons of alternatives depend on specific patient conditions and may be less precise.

Patient Experience

  • During the procedure, the patient may feel slight pressure or mild discomfort.
  • Post-procedure pain is typically minimal and can be managed with over-the-counter pain relievers.
  • Patients may feel relieved knowing the exact location of the lesion is marked for future treatment.

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