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General Surgery Coding Alert

Sentinel Node Biopsy and Lymphadenectomy Differ

Published on Mon Jul 04, 2005

More and more frequently, surgeons are forgoing lymph node excision (38745 by itself or 19162 with partial mastectomy) in favor of sentinel node biopsy, which you should report separately using 38500-38530, depending on the depth and location of the node.

Sentinel lymph node biopsy "allows sampling of the lymph node or nodes that receive drainage directly from  a tumor or an area of carcinoma," according to Medicare guidelines. In other words, such biopsies allow the surgeon to determine whether a cancer has spread to the most likely lymphatic drainage area or if it is contained  at the primary location. If the sentinel lymph node is negative for metastases, the surgeon need not perform a complete axillary lymphadenectomy.

Learn more: For complete information on sentinel node biopsy, see General Surgery Coding Alert June 2003, "Visualize Better Payment for Sentinel Node Biopsy Procedures," and July 2003, "Want to Improve Coding Accuracy for Sentinel Node Biopsies? Count Incisions, Not Excisions."
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