Advanced Search

Urology Coding Alert

You Be the Coder:

Stop Losing $15 Per Iliac Node Biopsy

Published on Fri Mar 06, 2009

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).
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All