What should be in the clinical notes before requesting Biopsy of each additional breast growth with a locating device using ultrasound (CPT 19084)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

CPT 19084: Biopsy of each additional breast growth with a locating device using ultrasound - Prior Authorization and Price

Home › CPT Codes › Biopsy of each additional breast growth with a locating device using ultrasound

CPT 19084

Biopsy of each additional breast growth with a locating device using ultrasound.

Other Imaging

Build a submission checklist for this study

Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Breast Imaging Guidelines 2.0.2026, effective Sep 1, 2026	1 that name this code
Anthem BCBS	Carelon	Current guideline	None found
Cigna	eviCore	Current guideline	None found
Medicare	CMS	—	None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	1 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Biopsy of each additional breast growth with a locating device using ultrasound. Each has its own criteria for when the study is considered appropriate.

Breast Ultrasound Aetna · UnitedHealthcare

Typical price

Commercial insurance, median

$1,384

Middle half of rates: $794 to $2,228

Medicare, physician fee schedule

$65

National, non-facility

Commercial figures come from negotiated rates published by 753 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Biopsy of each additional breast growth with a locating device using ultrasound change.

CPT 19084: Biopsy of each additional breast growth with a locating device using ultrasound - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET