# Mastectomy with sentinel lymph node



## Trendale (May 14, 2008)

Can someone tell me if a sentinel lymph node bx is bundled with the mastectomy or is it a separate payment?. It is the same incision site, do I code it separate with a 59?


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## efrohna (May 14, 2008)

Letisha, it depends on the _planned procedure_.

Example of when to bill both:  The planned procedure was mastectomy, partial, SLN bx returns from pathology as malignant.  (Results changed the planned procedure to mastectomy w/axilllary lymphadenectomy).
Remember to append 59 modifier to SLN Bx.

Example of when *NOT* to bill SLN Bx w/ Mastectomy:  The planned procedure was mastectomy w/axillary lymphadenectomy, SLN bx results are malignant.  (Results did not change planned procedure).				
Hopes this helps?


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## Trendale (May 20, 2008)

*Masectomy Reply*

Thank you Evangelina. The information you gave has been really helpful. Thanks!


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## cmartin (May 22, 2008)

It is coded separately when the mastectomy is partial or simple, and ONLY the sentinel node(s) removed.  
C.Martin, CPC-GENSG


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