Cervical Lymph node mapping

[Coastal Coder]

Good Afternoon,

I hope someone can help me find guidelines for Cervical lymph node mapping. My practice would like to start billing for this but I can't find any guidelines for documentation.

Thank you,

Michelle

 

[csperoni]

Lymph node mapping for identification of sentinel lymph node is billed as either:
38792 Injection procedure, radioactive tracer for identification of sentinel node
38900 Intraoperative identification of sentinel lymph node(s) includes injection of non-radioactive dye, when performed [ADD ON CODE to primary lymphadenectomy procedure]
If what your physicians are doing is not described by either of those, then your other option is 38999 unlisted lymphatic system.

I don't specifically bill for Interventional Radiology, but I do know that sentinel lymph node mapping over the past few years has increased in gynecologic procedures. During a robotic hysterectomy, the physician will inject a specific dye which "lights up" when viewed in the daVinci with a filter. My gyn onc docs call this a "Firefly Procedure". That helps them identify the sentinel lymph nodes which can then be removed. If that is what your IR physicians are doing, 38900 ALONG with the lymphadenectomy code is the correct billing.

 

[Coastal Coder]

Thank you for your reply,

I should have been more specific. We will be doing Ultrasound Neck mapping of the lymph nodes prior to surgery for Thyroid cancer.

Thank you

 

[csperoni]

Sorry - then I'm way off by assuming cervical you meant relating to the cervix and not actual cervical.
The closest thing I could find relating to this advises 76536 is really the only code to use. https://www.supercoder.com/my-ask-an-expert/topic/ultrasound-of-the-neck-for-lymph-nodes
Hope that helps!