karey
Networker
How would I code a Laparoscopic inguinal sentinel lymph node excision? This was done w/ a Lap Hysterectomy BSO 58571 and pelvic and peri-aortic lymph node dissection 38572.
Would I use 38589-Unlisted laparoscopy procedure, lymphatic system? What code would I use for the dye injection? 38900 or 38792? 38900 sounds to be more accuarate but it is an add on code and I am not coding any of the primary procedures that this code coinsides w/. Here is a portion of the Op report:
Would I use 38589-Unlisted laparoscopy procedure, lymphatic system? What code would I use for the dye injection? 38900 or 38792? 38900 sounds to be more accuarate but it is an add on code and I am not coding any of the primary procedures that this code coinsides w/. Here is a portion of the Op report:
[FONT=COURIER,sans-serif]Pneumoperitoneum was then created to a level not greater 15 mmHg.At [/FONT][FONT=COURIER,sans-serif]that time, 1 ml of Lymphazurin blue solution was placed at 3 o'clock and [/FONT][FONT=COURIER,sans-serif]9 o'clock in the cervix.[/FONT]
[FONT=COURIER,sans-serif] [/FONT]
[FONT=COURIER,sans-serif]Next the remaining three 8 mm robotic ports, 5 mm and 12 mm[/FONT]
[FONT=COURIER,sans-serif]laparoscopic ports were placed in left and right upper quadrant usual [/FONT][FONT=COURIER,sans-serif]locations without difficulty.Survey of the abdomen revealed no pelvic [/FONT][FONT=COURIER,sans-serif]or abdominal carcinomatosis. Diaphragm smooth.Liver smooth.Surfaces [/FONT][FONT=COURIER,sans-serif]of bowel were normal appearing.Omentum was normal appearing.The left [/FONT][FONT=COURIER,sans-serif]adnexa had a smooth simple cyst which was about 5 cm in diameter. [/FONT][FONT=COURIER,sans-serif]Prior to docking the robot ICG (green) dye was injected into the cervix [/FONT][FONT=COURIER,sans-serif]at 3 o'clock and 9 o'clock as well, 1 ml was used.The robot was then [/FONT][FONT=COURIER,sans-serif]docked in the usual fashion.[/FONT]
[FONT=COURIER,sans-serif] [/FONT]
[FONT=COURIER,sans-serif]The bilateral pelvic spaces were opened.Pararectal spaces and [/FONT][FONT=COURIER,sans-serif]paravesical spaces were opened in the usual fashion.Blue dye and green [/FONT][FONT=COURIER,sans-serif]dye was not noticed in the nodes on either area after multiple [/FONT][FONT=COURIER,sans-serif]observations.The lymphatics on the left did highlight was both blue [/FONT][FONT=COURIER,sans-serif]and green within the same channels leading directly to a lymph nodes [/FONT][FONT=COURIER,sans-serif]along the proximal left external iliac basin.This node was removed and [/FONT][FONT=COURIER,sans-serif]sent separately.Otherwise there were no other sentinel nodes in the [/FONT][FONT=COURIER,sans-serif]right pelvis or in the bilateral periaortic area[/FONT]
[FONT=COURIER,sans-serif] [/FONT]
[FONT=COURIER,sans-serif]Next the remaining three 8 mm robotic ports, 5 mm and 12 mm[/FONT]
[FONT=COURIER,sans-serif]laparoscopic ports were placed in left and right upper quadrant usual [/FONT][FONT=COURIER,sans-serif]locations without difficulty.Survey of the abdomen revealed no pelvic [/FONT][FONT=COURIER,sans-serif]or abdominal carcinomatosis. Diaphragm smooth.Liver smooth.Surfaces [/FONT][FONT=COURIER,sans-serif]of bowel were normal appearing.Omentum was normal appearing.The left [/FONT][FONT=COURIER,sans-serif]adnexa had a smooth simple cyst which was about 5 cm in diameter. [/FONT][FONT=COURIER,sans-serif]Prior to docking the robot ICG (green) dye was injected into the cervix [/FONT][FONT=COURIER,sans-serif]at 3 o'clock and 9 o'clock as well, 1 ml was used.The robot was then [/FONT][FONT=COURIER,sans-serif]docked in the usual fashion.[/FONT]
[FONT=COURIER,sans-serif] [/FONT]
[FONT=COURIER,sans-serif]The bilateral pelvic spaces were opened.Pararectal spaces and [/FONT][FONT=COURIER,sans-serif]paravesical spaces were opened in the usual fashion.Blue dye and green [/FONT][FONT=COURIER,sans-serif]dye was not noticed in the nodes on either area after multiple [/FONT][FONT=COURIER,sans-serif]observations.The lymphatics on the left did highlight was both blue [/FONT][FONT=COURIER,sans-serif]and green within the same channels leading directly to a lymph nodes [/FONT][FONT=COURIER,sans-serif]along the proximal left external iliac basin.This node was removed and [/FONT][FONT=COURIER,sans-serif]sent separately.Otherwise there were no other sentinel nodes in the [/FONT][FONT=COURIER,sans-serif]right pelvis or in the bilateral periaortic area[/FONT]