Urology Coding Alert

Question: What is the difference between a limited pelvic lymphadenectomy and a total bilateral pelvic lymphadenectomy? How many nodes must the doctor remove to report either a limited or total lymphadenectomy?

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Answer: There is no specific number of nodes that would indicate the type of node resection. A formal node  resection is accomplished when the urologist surgically cleans all tissue from a significant anatomical area, such as the pelvis or retroperitoneum, removing both lymph nodes and lymphatic channels. The following procedures represent regional radical lymphadenectomies (radical resection of lymph nodes):

38700 (Suprahyoid lymphadenectomy) and 38780 (Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes[separate procedure]).

The difference: A limited resection represents a small area from which the surgeon  removes only a small amount of lymphatic tissue or one or two lymph nodes.The following codes represent limited  ymphadenectomies (for staging of malignant diseases): 38562 (Limited lymphadenectomy for staging [separate procedure]; pelvic and para-aortic) and 38564 (... retroperitoneal [aortic/ and/or splenic]).