You Be the Coder:
Code Lymph Node-Less Radical Nephrectomy
Published on Sat Oct 11, 2003
Question: My urologist performed a laparoscopic radical nephrectomy but did not remove the regional lymph nodes. How should I report his services?
Maine Subscriber
Answer: You'll have to use modifier -52 (Reduced services) to indicate that the urologist did not perform all of the components.
The code for a laparoscopic radical nephrectomy (50545, Laparoscopy, surgical; radical nephrectomy [includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy]) includes the removal of regional lymph nodes, overlying fascia and Gerota's fascia as well as removal of the adrenal gland.
When you append modifier -52, the carrier will reduce the fee for your urologist's service depending on what the urologist documents performing. Be sure when you submit the paper claim you include a statement from the urologist stating, "I performed everything indicated by CPT 50545 except removal of the regional lymph nodes."
