Ask Dr. Z

With the improved developments for image guidance, many physicians now perform preoperative wire localization by "bracketing" a lesion. Coding of a single wire versus multiple wires to bracket a radiographic breast abnormality has been discussed, as it can be inconclusive as to whether a large mass is determined to be that of a single lesion, or a more complex mass possibly composed of more than one lesion. As there is much more work involved for the placement of multiple wires in order to bracket a lesion prior to surgery, it is appropriate for this scenario to utilize CPT 19291 and more than one unit of either guidance code (77031 or 77032)?