Wiki Lymphoscintigraphy

Create Wiki
When lymphoscintigraphy is performed in advance of the
surgical procedure to mark and locate the sentinel node(s), the
injection should be reported using CPT code 38792 and CPT
code 78195 should be used to report the lymphoscintigraphy.
 
I think they're bundled. 38792 is included in 78195. Not sure you can over ride that one. I could be wrong though. I bill for them once in awhile. Mine are usually just sentinel node injections. I also read a coding alert that said you can bill the injection twice if they're injecting more than 1 node. My docs make several injections but they're all for the same node so it's important to watch they're documentation.
 
Sentinel node

Sharing my thoughts in this senario:
78195 - Sulfide colloid is injected according to the lymph node to be visualized
Then imaging done.(Only colloid is injected and imaging done then code 78195)

But in

38792 - The physician injects dye or contrast material into the patient to identify the sentinel lymph node As soon as the node is visualized, the radiologist makes a small longitudinal incision over the area. The node is exposed and cannulated with a 27- or 30-gauge needle attached to a fine catheter(These procedure should mentioned)
 
I have coded both the 78195 and 38792 and insurance co's deny them stating 78195 is mutually exclusive to 38792. I have added a modifier onto the 78195 and havent received anything back from the insurance co yet. If anyone can shed some light on this topic for me I'd appreciate it.
 
keyne, which modifier did you use and who was the insurance co? So are we supposed to code only the 7000? or can we do both codes? Anyone who knows would be great. :)
 
jifnif said:
keyne, which modifier did you use and who was the insurance co? So are we supposed to code only the 7000? or can we do both codes? Anyone who knows would be great. :)
Click to expand...

I used the modifier 59 and it was Aetna. They paid the 38792 but didn't pay the 78195 with the modifier. The physicians are performing both procedures, and I want clarification before I tell them they can't bill for both.
 
You can only code 78195 OR 38792 - cannot code them together - Code 78195 includes the injection of the radioactive tracer. The separate injection code (38792) can only be used if the injection is performed and NO imaging occurs.
 
lymphoscintingraphy

I know we cannot code 78195 as well as 38792, but if we use ultrasoung guidance to perform injection can we use 76942. We are getting denials asking for modifier. Is it appropriate to add a 59 modifier? Thanks
 
You must log in or register to reply here.
Top