Radiology Coding Alert
Note Physician Requirements for 38792 Reporting
Question: If the provider performs a 38792 by the nuclear medicine technologist, and then sends the patient to the operating room (OR) for mapping sentinel node(s), can the radiologist bill for the injection? Does the radiologist, specifically, have to perform the injection — or can we add an attestation stating she was present during the injection? Louisiana Subscriber Answer: First, you will want to distinguish the two code possibilities that involve sentinel node mapping and injection: When the provider performs both the injection and the imaging for sentinel node identification, you will report code 78195. When the provider performs the injection without imaging, you will report 38792. In this example, since the patient is sent to the OR for the sentinel node mapping, 38792 is the only code in consideration. However, the provider is not eligible to report this code if the nuclear medicine technologist performs the injection. In fact, even if the physician is present for the injection, but the nuclear medicine technologist performs the injection, the physician still should not bill out 38792 separately. If the physician does not perform the injection, the service must be written off.
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