Mastectomy with sentinel lymph node

Trendale

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Jacksonville, FL
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Can someone tell me if a sentinel lymph node bx is bundled with the mastectomy or is it a separate payment?.:eek: It is the same incision site, do I code it separate with a 59?
 

efrohna

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Waterford, WI
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Letisha, it depends on the planned procedure.

Example of when to bill both: The planned procedure was mastectomy, partial, SLN bx returns from pathology as malignant. (Results changed the planned procedure to mastectomy w/axilllary lymphadenectomy).
Remember to append 59 modifier to SLN Bx.

Example of when NOT to bill SLN Bx w/ Mastectomy: The planned procedure was mastectomy w/axillary lymphadenectomy, SLN bx results are malignant. (Results did not change planned procedure).
Hopes this helps?
 

cmartin

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It is coded separately when the mastectomy is partial or simple, and ONLY the sentinel node(s) removed.
C.Martin, CPC-GENSG
 
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