Wiki Total mastectomy & sentinel node evaluation

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seslinger

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I am receiving conflicting coding information on the following procedure so I would like some input:

Via transverse incision, the sentinel node was removed & sent off to pathology. Other additional nodes that were enlarged were also removed. Attention towards breast, including the nipple-areolar complex, the flaps were raised superior to the clavicle, inferior to rectus abdominis, medial to the sternum, lateral to latissimus dorsi, & the breast was taken superior to inferior and medial to lateral pattern with care to take to pectoralis fascia in continuity; sent to pathology. I think 19307 ?? thank you
 
This doesn't sound like a radical mastectomy. I would query your doc. Did he/she make 2 incisions? One in the axilla and one on the breast? Did he inject dye to locate the sentinel node? I would be looking at 38500 (can only use 38525 if the doc hits level 2 or lower. Regarding the mastectomy, I would look at 19303 maybe? Just my thoughts
 
1 incision was made in the axillary & 1 incision into the breast. No documentation on the depth of the axillary nodes.
 
Total Mastectomy & Sent.Lymph node eval

I thought that the Mastectomy codes 19303 thru 19307 included the
sentinel lymph nodes and you could not bill separately for that. I am still
new at coding myself so thats why I am questioning this because I had
put a similar ? out re: Mastectomy, Sent.Lymph nodes bx and Inj.of dye
and what I could and couldnt code for. ? being Can I bill a Mastectomy
code with Sent.Lymph node bx and dye injection. Please Help!
TIA
Deb, CPC
 
After the dye has been injected and the physician uses the gamma probe to find the node/s you should be able to use 38308 for the mapping also. We do and do not have a problem getting reimbursement for this.dd
 
Total Mastectomy & Sent.lymph node eval

I would use the 38525 for the sent.lymph node eval (As this states axilla).
Just what I had been told to use along with Mastectomy.
Deb, CPC
 
i am almost a year late behind on this....can someone please help me with my question i have posted? it's regarding 19303 vs 19307 as well.

this is very confusing to me and i'm still quite new to breast surgery coding.
 
Total Mastectomy wit hsentinel lymph node bx and mapping

Hopp said:
I thought that the Mastectomy codes 19303 thru 19307 included the
sentinel lymph nodes and you could not bill separately for that. I am still
new at coding myself so thats why I am questioning this because I had
put a similar ? out re: Mastectomy, Sent.Lymph nodes bx and Inj.of dye
and what I could and couldnt code for. ? being Can I bill a Mastectomy
code with Sent.Lymph node bx and dye injection. Please Help!
TIA
Deb, CPC
Click to expand...

I would use: 19303, 38525 and 38792 or 38900.
Sincerely
Susan, COC, CPC
 
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