General Surgery Coding Alert

Question: What is the correct code for a laparoscopic retroperitoneal lymph node dissection (periaortic and interaortocaval lymph nodes)?

Texas Subscriber

Answer: You should report 38589 (Unlisted laparoscopic procedure, lymphatic system) for the service you describe, because there is no specific CPT^® code for this laparoscopic procedure.

When you submit an unlisted code you should always include a cover letter with your claim explaining that you have searched the active CPT^® codes and found no specific code for the procedure your surgeon performed. Use simple, straightforward language to explain exactly what the surgeon did and why an unlisted code fits best.

The Medicare Physician Fee Schedule does not include unlisted procedure codes, so the codes do not have assigned fees or global periods. When you submit an unlisted code, suggest a fee by comparing the procedure your surgeon completed to a similar procedure with a specific CPT^® code and an established reimbursement value. In this case, you might benchmark to an open retroperitoneal node resection, 38780 (Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes [separate procedure]).