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).
