Right Axillary Sentinel Node Biopsy-billing 38792 twice?

dreampeddler

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I'm auditing the charges for a provider billing for both a right simple mastectomy as well as a right axillary sentinel node biospy.

The physician administered both Filtered Technetium at the 6 o clock position of the right areola, as well as Methylene Blue in the subareolar area.

The total bill came to us with the following codes:
01 19303 MASTECTOMY, SIMPLE, COMPLETE
02 38525 BIOPSY OR EXCISION OF LYMPH NODE(S); OP
03 38792-51 INJECTION PROCEDURE; FOR IDENTIFICATION
04 38792-51-RT INJECTION PROCEDURE; FOR IDENTIFICATION

Is it appropriate for the provider to bill the 38792 twice, using these modifiers?

Thanks!

Jodie, CPC
 
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cmartin

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Our Medicare carrier said that it was. I posted the info somewhere in these forums some time back; if I can find it, I'll repost it here.
C.Martin
ran down this item I posted months ago on a related subject - maybe the article referred to can help?
C.Martin
CPC-GENSG
Our Medicare B Carrier, National Govt Services, just released sentinel lymph node policy, Article A47181, which states that 38792 is appropo for the surgeon injecting dye AND/OR other substances for ID of sentinel node.
"CPT code 38792 can be billed for both the injection of radioactive tracer when performed without lymphoscintigraphy; and for the injection of vital dye (Isosulfan Blue Dye or a similar product) to visualize the sentinel node, by the surgeon/physician who performs the injection." [I cut and pasted that line from the article on the NGS website]
Connie Martin
 
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