# Need help!!  Coding CPT 38972



## Nita Bhatt (Apr 11, 2017)

Can some tell me if we can bill CPT code 38972 for injecting of Indocyanine green dye  and Isosulfan blue dye for Sentinel Lymph Node Excisions with Robotic Hysterectomy, Bilateral Salping-oopharectomy ??

The doctor injects the dye before excising the  bilateral lymph Nodes, and later does the hysterectomy+ BSO

58571
38570
38972


or injecting of the dye is inclusive in the hysterectomy and Sentinel Biopsy procedure  and cannot be billed separately ???

Thanks 
N


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## csperoni (May 9, 2017)

*Welcome to unlisted codes*

I think you had a typo and meant 38792 (not 38972), but regardless, that is unfortunately not the correct code as it is not a radioactive tracer.  38900 exactly precisely describes the procedure that is done.
38900 - Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed.  
The problem?  38900 is an ADD ON code.  And laparoscopic hysterectomy and/or laparoscopic lymphadenectomy are not base codes for it.  It can only be coded with 19302, 19307, 38500, 38510, 38520, 38525, 38530, 38542, 38740 & 38745.  
The Society of Gynecologic Oncologists has an article in their September 22, 2016 newsletter about it. 

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https://www.sgo.org/newsroom/sgo-issues/sgo-issues-sept-22-2016/#article2
```
Here is what I do since my gyn onc does a ton of these Firefly procedures.  
1) Some (but not many) carriers don't realize 38900 is an add on code and will pay even without billing one of the base codes.  That's the best situation.
2) For carriers that will not pay 38900 without the base code, I use 38999.  And then of course, will submit the operative report and a letter requesting it be valued as 150% of 38900.  Expect it to take at least 3 months to see any payment for 38999.  
I'm not OK with giving away the additional work and skill involved and not billing for it.
Good luck!


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## csperoni (Feb 11, 2019)

*2019 update*

Since I posted this answer in 2017 & I know people often reference previous posts, I thought it important to update my answer.
38900 add on code is now billable with 38570-38572 for the laparoscopic lymphadenectomy as of 2019. You no longer need to use unlisted 38999. 

The full list of base codes for 38900 mapping is now  19302, 19307, 38500, 38510, 38520, 38525, 38530, 38531, 38542, 38562, 38564, 38570, 38571, 38572, 38740, 38745, 38760, 38765, 38770, 38780, 56630, 56631, 56632, 56633, 56634, 56637, 56640


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