![]() If the surgeon prospectively plans to perform lymphadenectomy, you should not separately report a sentinel node biopsy. Medicare says: Sentinal lymph node biopsy for malignant melanoma is eligible for reimbursement unless a regional lymphadenectomy is planned, regardless of the findings of the. Instead, you should include the sentinel node biopsy in the more extensive, same-location lymphadenectomy. CPT Codes for Sentinal Node Biopsy with LymphadenectomyYou should not separately report Sentinal Node Biopsy (38500-38530) and a planned lymphadenectomy (38700-38780) in the same region during the same operative session. In addition, your documentation should make clear that the biopsy results provided the justification for and led to the decision to perform the subsequent excisions. Modifier 59 with CPT Code 38500-38530Many payers will require that you append modifier 59 (Distinct procedural service) to the appropriate biopsy code (38500-38530) to further differentiate the procedure from the follow-up lymphadenectomy. The pathology report indicates that the malignancy has spread, so the surgeon follows up with a lymphadenectomy (for example, 38745, Axillary lymphadenectomy complete) to remove the affected tissue.In above case, because the biopsy led to the decision to perform the mastectomy, you may report both 3855.
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