natashalage
Expert
Hello,
I am looking for help to understand when we code 38570 vs 38571.
38570-Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple
38571-Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
I read the descriptions of CPT and understood that sentinel nodes/Bx will be coded under 38570 because it’s a sample, first time learning about the disease. Sentinel nodes can be in different areas of the body. What I don’t understand is then MD is using 2 words ‘sentinel pelvic nodes are excised” Did he excise sentinel 38570 or pelvic nodes 38571? I am lost. I have 2 examples below for your review and will greatly appreciate your help on these 2 codes and what to look for in the Op note.
Thank you very much in advance.
MD performs Lap hysterectomy with:
Case 1… with sentinel lymph node mapping +38900 with pelvic lymph node biopsies. “We discussed a minimally invasive surgical staging procedure with sentinel lymph node mapping. ‘as a candidate sentinel lymph node, and therefore we excised both these as our biopsy specimens”
Path: Left &Right obturator sentinel lymph node + L&R external iliac sentinel lymph node. Number of sentinel nodes examined: 5.
I would code it as sentinel node resection only- 38570. Is that right?
Case 2. Lap Uterus+ bilateral pelvic sentinel lymph node dissection. ‘We took the lymph nodes that were both at the bifurcation of the external iliac vein. The obturator nerves were identified bilaterally just underlying the sentinel nodes. Specimens: bilateral sentinel pelvic lymph nodes.
Path: Left pelvic sentinel lymph node, biopsy: No tumor (0/1).
C. Right pelvic sentinel lymph node, biopsy: No tumor (0/1).
Is that sentinel nodes 38570 or pelvic 38571? I am struggling with it all afternoon.
I am looking for help to understand when we code 38570 vs 38571.
38570-Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple
38571-Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
I read the descriptions of CPT and understood that sentinel nodes/Bx will be coded under 38570 because it’s a sample, first time learning about the disease. Sentinel nodes can be in different areas of the body. What I don’t understand is then MD is using 2 words ‘sentinel pelvic nodes are excised” Did he excise sentinel 38570 or pelvic nodes 38571? I am lost. I have 2 examples below for your review and will greatly appreciate your help on these 2 codes and what to look for in the Op note.
Thank you very much in advance.
MD performs Lap hysterectomy with:
Case 1… with sentinel lymph node mapping +38900 with pelvic lymph node biopsies. “We discussed a minimally invasive surgical staging procedure with sentinel lymph node mapping. ‘as a candidate sentinel lymph node, and therefore we excised both these as our biopsy specimens”
Path: Left &Right obturator sentinel lymph node + L&R external iliac sentinel lymph node. Number of sentinel nodes examined: 5.
I would code it as sentinel node resection only- 38570. Is that right?
Case 2. Lap Uterus+ bilateral pelvic sentinel lymph node dissection. ‘We took the lymph nodes that were both at the bifurcation of the external iliac vein. The obturator nerves were identified bilaterally just underlying the sentinel nodes. Specimens: bilateral sentinel pelvic lymph nodes.
Path: Left pelvic sentinel lymph node, biopsy: No tumor (0/1).
C. Right pelvic sentinel lymph node, biopsy: No tumor (0/1).
Is that sentinel nodes 38570 or pelvic 38571? I am struggling with it all afternoon.