# Alcohol ablation submandibular lymph node



## jpollard (Nov 24, 2014)

I am stumped!!  My Radiologist just completed an Ultrasound guided alcohol ablation of a submandibular lymph node for metastatic thyroid cancer.  Would this be the unlisted code 38999?  Any help is greatly appreciated.  

"After perinodal anesthesia and skin cleansing the 25-guage needle was passed into this lymph node.  The node was treated from its most distal peripheral points proximally.  Small applications of alcohol were instilled under ultrasound guidance.  Needle tip is visualized at all times.  A total 0.6 ml of alcohol was utilized.


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## Mary Ann Baldyga (Nov 24, 2014)

jpollard said:


> I am stumped!!  My Radiologist just completed an Ultrasound guided alcohol ablation of a submandibular lymph node for metastatic thyroid cancer.  Would this be the unlisted code 38999?  Any help is greatly appreciated.
> 
> "After perinodal anesthesia and skin cleansing the 25-guage needle was passed into this lymph node.  The node was treated from its most distal peripheral points proximally.  Small applications of alcohol were instilled under ultrasound guidance.  Needle tip is visualized at all times.  A total 0.6 ml of alcohol was utilized.



*Use 20500*
ACR Radiology Coding Source? for July-August 2012 << Previous 
The appropriate codes to report sclerotherapy of nonvascular structures, such as a lymphocele, are 20500, Injection of sinus tract; therapeutic (separate procedure), and 76080, Radiologic examination, abscess, fistula or sinus tract study, radiological supervision and interpretation. The ACR and Society of Interventional Radiology agree that these CPT codes should be reported for all non-vascular sclerosis procedures (e.g., seroma, cyst, lymphocele, abscess) and that the use of different agents (e.g., alcohol, tetracycline, betadine) does not limit or alter the reporting of these codes. 
Moderate (conscious) sedation is not included in the 20500 code, therefore, it also may be reported separately when performed (e.g., 99144, 99145)


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## jpollard (Nov 25, 2014)

Thank you so much.  I have looked this up and printed it for future reference.  I appreciate your prompt response.  Have a safe, wonderful Thanksgiving.


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