Wiki 38792 vs 38900

[ksb0211]

I've received a couple different answers to this, so I'm wondering if someone out there has some clarification.

Example: mastectomy is performed, sentinel node dissection. Dr inject methylene blue and utilizes for identification. We used to bill 38792. I've been told by a couple different coders completely different answers as to bill 38900 or 38792. I have the Ingenix General Surgery/Gastroenterology Coding Companion, but I'm still utterly confused.

Is there anyone out there who may have some clarification as to what the difference is between the two codes???

Thanks so much!

~Kelly~

 

[surgonc87]

38900 is a new code for 2011. Now we have two choices. We have to default to 38792 if 38900 is not a "PX" of the reporting CPT code. Here are the PrimaryPX to 38900. So everything in between like 19301,19303,19304,19305,19306 would use 38972.


19302 Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy); with axillary lymphadenectomy
19307 Mastectomy, modified radical, including axillary lymph nodes, with or without pectoralis minor muscle, but excluding pectoralis major muscle
38500 Biopsy or excision of lymph node(s); open, superficial
38510 Biopsy or excision of lymph node(s); open, deep cervical node(s)
38520 Biopsy or excision of lymph node(s); open, deep cervical node(s) with excision scalene fat pad
38525 Biopsy or excision of lymph node(s); open, deep axillary node(s)
38530 Biopsy or excision of lymph node(s); open, internal mammary node(s)
38542 Dissection, deep jugular node(s)
38740 Axillary lymphadenectomy; superficial
38745 Axillary lymphadenectomy; complete

MS

 

[ksb0211]

Thanks!!