stephanie.henderson
Guest
I am looking for a CPT code to for the excision of the left external iliac node, deep.
OPERATIVE PROCEDURE: brought into the operating room and placed on the operating table in the supine position. He underwent lma get anesthesia, was prepped with chloroprep and draped in the usual sterile fashion. An appropriate timeout was held. The nodes were marked on the skin from the radioactive injection and lymphoscintography, one below and one above the left inguinal ligament. The skin above the melanoma was infiltrated with 3 cc of a dilute methylene blue dye in the dermis in several aliquots. The area was massaged. Attention was first turned to the superficial node. A horizontal incision was made just below the groin crease over the radioactively hot area found also by the neoprobe. Dissection was carried down to expose the blue , hot node next to the femoral vein. The node was dissected free and hemo and lymphostasis achieved with clips. The count on this node was 621 and background 10. The incision was closed with three layers of vicryl and steristrips. Attention was then turned to the superiorly located node. An incision was mad just above the inguinal ligament in the skin and dissection carried down to the external oblique aponeurosis which was opened, The dissection was then carried down through the floor of the canal to the external iliac vein and a hot node located with the neoprobe, this was excised and count 556, background count 45. Hemostasis and lymphostasis achieved with clips. The floor of the cancal suture with silk, external oblique closed with 3 vicryl as well as scarpa's and skin closed with two layers of vicryl. steristrips placed. Dressings placed. All counts correct.
The provider wants to bill 38500 and 38900 but does not know what to use for the deep external iliac node.
Suggestions?
Thanks
OPERATIVE PROCEDURE: brought into the operating room and placed on the operating table in the supine position. He underwent lma get anesthesia, was prepped with chloroprep and draped in the usual sterile fashion. An appropriate timeout was held. The nodes were marked on the skin from the radioactive injection and lymphoscintography, one below and one above the left inguinal ligament. The skin above the melanoma was infiltrated with 3 cc of a dilute methylene blue dye in the dermis in several aliquots. The area was massaged. Attention was first turned to the superficial node. A horizontal incision was made just below the groin crease over the radioactively hot area found also by the neoprobe. Dissection was carried down to expose the blue , hot node next to the femoral vein. The node was dissected free and hemo and lymphostasis achieved with clips. The count on this node was 621 and background 10. The incision was closed with three layers of vicryl and steristrips. Attention was then turned to the superiorly located node. An incision was mad just above the inguinal ligament in the skin and dissection carried down to the external oblique aponeurosis which was opened, The dissection was then carried down through the floor of the canal to the external iliac vein and a hot node located with the neoprobe, this was excised and count 556, background count 45. Hemostasis and lymphostasis achieved with clips. The floor of the cancal suture with silk, external oblique closed with 3 vicryl as well as scarpa's and skin closed with two layers of vicryl. steristrips placed. Dressings placed. All counts correct.
The provider wants to bill 38500 and 38900 but does not know what to use for the deep external iliac node.
Suggestions?
Thanks