# Total mastectomy & sentinel node evaluation



## seslinger (Mar 26, 2010)

I am receiving conflicting coding information on the following procedure so I would like some input:

Via transverse incision, the sentinel node was removed & sent off to pathology.  Other additional nodes that were enlarged were also removed.  Attention towards breast, including the nipple-areolar complex, the flaps were raised superior to the clavicle, inferior to rectus abdominis, medial to the sternum, lateral to latissimus dorsi, & the breast was taken superior to inferior and medial to lateral pattern with care to take to pectoralis fascia in continuity; sent to pathology.    I think 19307 ??  thank you


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## jaimewicklund (Mar 30, 2010)

This doesn't sound like a radical mastectomy. I would query your doc. Did he/she make 2 incisions? One in the axilla and one on the breast? Did he inject dye to locate the sentinel node? I would be looking at 38500 (can only use 38525 if the doc hits level 2 or lower. Regarding the mastectomy, I would look at 19303 maybe? Just my thoughts


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## seslinger (Mar 31, 2010)

1 incision was made in the axillary & 1 incision into the breast. No documentation on the depth of the axillary nodes.


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## jaimewicklund (Mar 31, 2010)

then I would code 19303 and 38500. (query the physician about injecting dye intraoperatively.. if so then 38792 as well)


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## Hopp (Apr 19, 2010)

*Total Mastectomy & Sent.Lymph node eval*

I thought that the Mastectomy codes 19303 thru 19307 included the
sentinel lymph nodes and you could not bill separately for that.  I am still
new at coding myself so thats why I am questioning this because I had
put a similar ? out re: Mastectomy, Sent.Lymph nodes bx and Inj.of dye
and what I could and couldnt code for.   ? being Can I bill a Mastectomy
code with Sent.Lymph node bx and dye injection.   Please Help!
TIA  
Deb, CPC


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## Pebbles1218 (Apr 20, 2010)

After the dye has been injected and the physician uses the gamma probe to find the node/s you should be able to use 38308 for the mapping also.   We do and do not have a problem getting reimbursement for this.dd


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## Hopp (Apr 21, 2010)

*Total Mastectomy & Sent.lymph node eval*

I would use the 38525 for the sent.lymph node eval (As this states axilla).
Just what I had been told to use along with Mastectomy.
Deb, CPC


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## mizzmaryb (Jan 31, 2011)

i am almost a year late behind on this....can someone please help me with my question i have posted? it's regarding 19303 vs 19307 as well. 

this is very confusing to me and i'm still quite new to breast surgery coding.


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## seisenhauer (Jul 12, 2018)

*Total Mastectomy wit hsentinel lymph node bx  and mapping*



Hopp said:


> I thought that the Mastectomy codes 19303 thru 19307 included the
> sentinel lymph nodes and you could not bill separately for that.  I am still
> new at coding myself so thats why I am questioning this because I had
> put a similar ? out re: Mastectomy, Sent.Lymph nodes bx and Inj.of dye
> ...



I would use:  19303, 38525 and 38792 or 38900.
Sincerely
Susan, COC, CPC


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