38500 or 38510? please help

BFAITHFUL

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need help with the following, CPT 38500 because first paragraph states (more superficial) but our doc keeps telling us it should be 38510 because it was within the subcutaneous tissue??? Thanks

DX: Lymphoma

Right supraclavicular lymph node biopsy

Patient had multiple cervical nodes and had one just above the clavicle, which seem in the more superficial. This was biopsied.

A transverse incision was made with the scalpel and dissected down through the skin into the subcutaneous tissue down to the level of the node. The node was then circumferentially dissected free using the Metzenbaum scissors several supplying blood vessels were cauterized with the Bovie. The node was excised intact. A small edge of the node was excised and divided and sent the cultures for routine culture and sensitivity, TB and fungus. The remainder of the node was placed in saline for pathologic (histologic) examination. Hemostasis having been obtained. The wound was closed in running 3-0 vicryl subcutaneously and a subcuticular 4-0 Monocryl running for the skin. SteriStrips and sterile dressing were applied .
 
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