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CMS Transmittals



National Coverage Determination
Procedure Code: 19083
Percutaneous Image Guided Breast Biopsy
CMS Policy Number: 220.13
Back to NCD List



To review all requirements of this policy, please see: CMS NCD listing by Chapter

Covered ICD-10 Codes.

ICD-10Descriptor
C50.011 Malignant neoplasm of nipple and areola, right female breast
C50.012 Malignant neoplasm of nipple and areola, left female breast
C50.021 Malignant neoplasm of nipple and areola, right male breast
C50.022 Malignant neoplasm of nipple and areola, left male breast
C50.111 Malignant neoplasm of central portion of right female breast
C50.112 Malignant neoplasm of central portion of left female breast
C50.121 Malignant neoplasm of central portion of right male breast
C50.122 Malignant neoplasm of central portion of left male breast
C50.211 Malig neoplm of upper-inner quadrant of right female breast
C50.212 Malig neoplasm of upper-inner quadrant of left female breast
C50.221 Malig neoplasm of upper-inner quadrant of right male breast
C50.222 Malig neoplasm of upper-inner quadrant of left male breast
C50.311 Malig neoplm of lower-inner quadrant of right female breast
C50.312 Malig neoplasm of lower-inner quadrant of left female breast
C50.321 Malig neoplasm of lower-inner quadrant of right male breast
C50.322 Malig neoplasm of lower-inner quadrant of left male breast
C50.411 Malig neoplm of upper-outer quadrant of right female breast
C50.412 Malig neoplasm of upper-outer quadrant of left female breast
C50.421 Malig neoplasm of upper-outer quadrant of right male breast
C50.422 Malig neoplasm of upper-outer quadrant of left male breast
C50.511 Malig neoplm of lower-outer quadrant of right female breast
C50.512 Malig neoplasm of lower-outer quadrant of left female breast
C50.521 Malig neoplasm of lower-outer quadrant of right male breast
C50.522 Malig neoplasm of lower-outer quadrant of left male breast
C50.611 Malignant neoplasm of axillary tail of right female breast
C50.612 Malignant neoplasm of axillary tail of left female breast
C50.621 Malignant neoplasm of axillary tail of right male breast
C50.622 Malignant neoplasm of axillary tail of left male breast
C50.811 Malignant neoplasm of ovrlp sites of right female breast
C50.812 Malignant neoplasm of ovrlp sites of left female breast
C50.821 Malignant neoplasm of overlapping sites of right male breast
C50.822 Malignant neoplasm of overlapping sites of left male breast
C50.911 Malignant neoplasm of unsp site of right female breast
C50.912 Malignant neoplasm of unspecified site of left female breast
C50.921 Malignant neoplasm of unspecified site of right male breast
C50.922 Malignant neoplasm of unspecified site of left male breast
D05.01 Lobular carcinoma in situ of right breast
D05.02 Lobular carcinoma in situ of left breast
D05.11 Intraductal carcinoma in situ of right breast
D05.12 Intraductal carcinoma in situ of left breast
D05.81 Other specified type of carcinoma in situ of right breast
D05.82 Other specified type of carcinoma in situ of left breast
D05.91 Unspecified type of carcinoma in situ of right breast
D05.92 Unspecified type of carcinoma in situ of left breast
D48.61 Neoplasm of uncertain behavior of right breast
D48.62 Neoplasm of uncertain behavior of left breast
N63.11 Unspecified lump in the right breast, upper outer quadrant
N63.12 Unspecified lump in the right breast, upper inner quadrant
N63.13 Unspecified lump in the right breast, lower outer quadrant
N63.14 Unspecified lump in the right breast, lower inner quadrant
N63.21 Unspecified lump in the left breast, upper outer quadrant
N63.22 Unspecified lump in the left breast, upper inner quadrant
N63.23 Unspecified lump in the left breast, lower outer quadrant
N63.24 Unspecified lump in the left breast, lower inner quadrant
N63.31 Unspecified lump in axillary tail of the right breast
N63.32 Unspecified lump in axillary tail of the left breast
N63.41 Unspecified lump in right breast, subareolar
N63.42 Unspecified lump in left breast, subareolar
R92.0 Mammographic microcalcification found on dx imaging of brst
R92.1 Mammographic calcifcn found on diagnostic imaging of breast
R92.8 Oth abn and inconclusive findings on dx imaging of breast

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