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General Surgery Coding Alert

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Is Node Biopsy Separate With Mastectomy?

Published on Sat Jan 06, 2007

Question: May we report sentinel node biopsy separately with a partial mastectomy, or is the biopsy bundled to the excision? Missouri Subscriber  


Answer: Instructions added to version 10.1 of the national Correct Coding Initiative (CCI) -- which have remained a part of the introductory text preceding 30000-39599 -- advise, -sentinel lymph node biopsy is separately reported when performed prior to a localized excision of breast or a mastectomy with or without lymphadenectomy.-

In other words, yes, you may report 38500 (Biopsy or excision of lymph node[s]; open, superficial), 38525 (... open, deep axillary node[s]) or 38530 (... open, internal mammary node[s]), as appropriate, for sentinel node biopsy during the same session with 19301 (Mastectomy, partial [e.g., lumpectomy, tylectomy, quadrantectomy, segmentectomy]) or 19302 (... with axillary lymphadenectomy).
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