# CPT for Sentinel Lymph node biopsy



## kmartinez (Feb 11, 2019)

I have seen to use an unlisted code for the "deep" inguinal CPT 38999. I have also read to use 38500 and 38505, or 38525 so I am kind of at a loss as to what direction to go. 

Plan for incision was made in the right inguinal region overlying the area of the 2 lymph nodes that had been detected on lymph node mapping. At the site of the greatest counts on the Neoprobe, an incision was made after infiltration into the skin with 0.5% sensorcaine with epinephrine. The incision was carried down through the subcutaneous tissue and through the fascia overlying the lymph nodes. The Neoprobe was used to detect a lymph node and dissection of this lymph node was performed. The lymphatic channels were clipped with Hemoclips. The lymph node was then passed off the sterile field and sent to pathology...the wound was closed in layers using 3-0 vicryl for the deep dermis and 4-0 monocryl for the skin in a running subcuticular fashion. 

Provider then goes on to do an excision of a lesion on the right inner thigh. 

I would appreciate any help as to what CPT would be correct regarding this type of scenario. 
KM


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## csperoni (Feb 11, 2019)

*Updated for 2019*

This is one of those situations where previous answers and guidance may no longer be accurate.  

The previous guidance was probably the best option before 2019. However, there is now a new code 38531 for open inguinofemoral lymph node biopsy.  For the mapping, I'm not familiar with the Neoprobe, but I believe with that procedure, it is a radioactive tracer, so 38792 for identification of the sentinel node.  If the injection given is NOT radioactive (like ICG dye done in gyn onc), then add on code 38900 for the sentinel lymph node mapping.  38531 is a base code that allows the add on.


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## kmartinez (Feb 12, 2019)

I completely missed that new code! Thank you so much for your help and all your input.


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