Otolaryngology Coding Alert
Removal of Facial Lymph Node
California Subscriber
Answer: The lymph nodes in the jaw and face area are superficial to (and occasionally embedded in) the parotid gland, and should be coded as 38500 (excision of superficial lymph node[s]) even when they have to be dissected out of the gland, says Eric Sandham, CPC, a compliance educator with Central California Faculty Medical Group in Fresno, Calif. If the approach begins from underneath the mandible (jawbone) and involves limited upper cervical (neck) dissection, they could represent a cervical lymph node excision (38510) or suprahyoid lymphadenectomy (38700). Jugular lymph nodes are located adjacent to the sternocleidomastoid muscles (the large muscles that go up either side of the neck), and would be coded 38542 if they were excised.
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