Wiki 22903/38500 vs 38531

[nlbarnes]

The provider submitted 22093 & 38500. I'm looking at 38531 but I've been out of the game for a bit. I think I'll need to query further but needed a starting point. Thanks...

The procedure began with 2 mL 0.25% Marcaine used to anesthetize the skin at the line of planned incision in the right inguinal . The 15 blade scalpel was then used to perform 3 cm incision over the palpable lymph node. The incision was carried down with the help of Bovie cautery and superior and inferior skin flaps were created. The lymph node was identified, and the afferent and efferent lymphatics were clipped with titanium clips. The lymph node was then completely excised free from the surrounding tissues with the cautery. Meticulous surgical hemostasis was achieved. The specimen was passed off the procedure table and sent to pathology fresh.

The fascia was then repaired with a running 3-0 Vicryl suture. 3-0 Vicryl suture was then used to approximate the deep dermal layer with multiple interrupted sutures. Finally, the skin was closed with 4-0 Monocryl suture, using subcuticular running suture technique. Dermabond dressing was applied.

 

[MI_CODER]

I agree with you and would code the inguinal lymph node excision as 38531.

CPT Lay Description 38500-38531

The physician performs a biopsy on or removes one or more superficial lymph nodes in 38500. The physician makes a small incision through the skin overlying the lymph node. The tissue is dissected to the node. A small piece of the node and surrounding tissue are removed, or the entire node may be removed. The incision is repaired with a layered closure. Report 38505 if a needle is used, other than fine needle aspiration, for superficial lymph nodes such as those in the axillary, cervical, or inguinal regions. Report 38510 if deep cervical nodes are biopsied or removed and 38520 if the scalene fat pad is also excised. Report 38525 if the biopsy or excision involves the deep axillary nodes and 38530 for the internal mammary nodes. For biopsy or excision of the inguinofemoral (groin) nodes, report 38531. Removal of deep nodes may necessitate the placement of a subcutaneous drain, as well as a layered closure.