Urology Coding Alert

Question: The urologist says he biopsied the iliac node. I can't find a code for this procedure. What should I use? Oregon Subscriber Answer: You should use CPT 38562 (Limited lymphadenectomy for staging [separate procedure]; pelvic and para-aortic) if your urologist's documentation indicates that he performed a simple excision of one or more pelvic nodes. However, if he only performed a biopsy of a lymph node, report 27041 (Biopsy, soft tissue of pelvis and hip area; deep, subfascial, intramuscular) instead. Don't lose money: If you're not checking for an excision, and you're just reporting 27041 for this procedure, you could be costing your practice money. Code 38562 reimburses $650.64, and code 27041 reimburses $635.85 (2009 unadjusted rates based on the Medicare fee schedule).