Anesthesia Coding Alert

Question: What is a Chamberlain procedure, and how should I report it?

Montana Subscriber
 
Answer: Chamberlain procedure" is another name for mediastinotomy, an outpatient procedure done under general anesthesia to sample the mediastinal lymph nodes. Some coders consider the surgical code to be either 39010 (Mediastinotomy with exploration, drainage, removal of foreign body, or biopsy; transthoracic approach, including either transthoracic or median sternotomy) or 39400 (Mediastinoscopy, with or without biopsy).

Code 39010 involves a thoracotomy, which is an open chest procedure that may be accompanied by a chest tube. This is a more involved approach to the procedure and coincides with either 00540 (Anesthesia for thoracotomy procedures involving lungs, pleura, diaphragm, and mediastinum [including surgical thoracoscopy]; not otherwise specified) or 00541 (... utilizing one-lung ventilation) for anesthesia. However, reporting 00541 would be rare because anesthesiologists normally do not perform mediastinoscopy using one-lung ventilation.

If the physician uses a scope instead of conducting an open procedure, report 00528 (Anesthesia for closed chest procedures; mediastinoscopy and diagnostic thoracoscopy not utilizing one-lung ventilation) to correspond with surgical code 39400. This approach is most common for outpatient surgery.