Billing and Coding: Tomosynthesis-Guided Breast Biopsy

Tomosynthesis-only percutaneous breast biopsies and tomosynthesis-only localization placements should be reported with CPT 19499 and the procedure name documented in claim narrative fields. When stereotactic and tomosynthesis guidance are both used, use CPT 19081; multiple lesions on the same date require modifier -59 for additional same-breast lesions or modifier -50 for bilateral procedures. Placement of localization devices (CPT 19281-19288) and post-biopsy mammograms (77065/77067 +/- G0279) performed the same day are considered inclusive to the tomosynthesis-guided procedure and are not separately payable; additional non‑mammography imaging on the same date will be denied unless modifier -59 is appended and documentation supports the modality change.

"When digital breast tomosynthesis is the only imaging guidance used for a percutaneous core needle breast biopsy, bill CPT 19499 (Unlisted procedure, breast) and document the procedure name in the ..."