Wiki Can we code lymph mapping with Radical trachelectomy +pelvic lymphadenectomy?

[natashalage]

Hello coding community. Could you please help me with a question: can we code lymph node mapping 38900 with 57531? Thank you very much in advance!

Coding tips for 38900 in Encoder 'Report 38900 in addition to 19302, 19307, 38500, 38510-38542, 38562, 38564, 38570-38572, 38740, or 38745, 38760-38780, 56630-56634, 56637, 56640 .” My code 57531 is not there but per CCI edits, there is no issue.
I included just a piece of Op note, trachelectomy was done, some pelvic nodes were excised except para-aortic = 57531-52. I got puzzled on mapping 38900.

OPERATION: Exploratory laparotomy, modified radical trachelectomy= 57531, bilateral sentinel lymph node mapping 38900 with resection
FINDINGS:
2. ICG mapped bilaterally to the obturator nodes

OPERATIVE PROCEDURE:

A well-lubricated 21 Fr 30 degree rigid cystoscope per urethra and into the bladder…
As we intended to perform a sentinel lymph node mapping procedure. We diluted 25 mg of indocyanine green into 20 mL of sterile water (1.25mg/mL). We injected 4 mL total into the cervix at 3 o'clock and 9 o'clock.

We then proceeded with the laparotomy. …

We used the Novadaq Spy equipment with near infra-red camera filter to do lymphatic mapping. See above "findings" for description. The sentinel nodes were grasped with Singley forceps and harvested from the vessels and surrounding fatty lymphoid tissue.

 

[Cmama12]

No, because it's an add-on code, you can only use it with the specified codes. You would need to use unlisted code 38999 with 57531

 

[csperoni]

Yes, 38900 should only be billed with one of the base codes.
With that being said, from experience (prior to 2019 when the additional base codes were added), there are some carriers that do not require one of the base codes to process 38900 (Empire BCBS comes to mind).
38999 is the "correct" code. 38900 is what actually describes what was done.