Wiki Sentinel Node Biopsy/Mapping 38525/38900

[jepcpc]

CPT: 38900 Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure



Does anyone bill CPT 38900, if the patient is sent to Radiology for the injection of the radioactive dye, but, then is brought to the Operating Room to do the identification by Gamma Probe? The physician uses the Gamma Probe, then removes the Sentinel Node(s). I have been coding 38525 only - as per the physician. Physician states since he does not inject the radioactive dye, it should not be coded. Thoughts?

 

[syllingk]

Yes. No. Code +38900 is not for the radioactive dye. that is code 38792. Code +38900 is if the doc injects methelyne blue(non-radioactive) to help map the nodes when the tracer doesn't work very well.

 

[jepcpc]

Correct. All my doctor is doing is using the Gamma Probe. Someone else is injecting the radioactive dye. A fellow coder suggested that I should bill for the mapping since the physician is using the gamma probe to find the lymph nodes that he will be removing.

 

[Venkatakrishnan]

Hi Jep,

In the documentation, radioactive dye was injected. As per Syllingk, 38792 is correct for RADIOACTIVE TRACER. In CPT 38792 only injection component is found which was not done by your Physician. So you can not bill this CPT 38792 on your Physician's claim.

Thanks,
Vernon Kreiss

 

[elsaee87]

According to Zupko, you can use +38900 for the Mapping of sentinel node with gamma probe. The description for +38900 says "include injection of non-radioactive dye when performed" so maybe that's why.

https://karenzupko.com/sentinel-node-identification/#:~:text=CPT%20%2B38900%20covers%20the%20intraoperative,identify%20the%20sentinel%20lymph%20node.