Wiki thoracic lymphadenectomy

[sbetts]

hi,

The surgeon did a thoracotomy with a pleural bx (32098) and removed a large aortopulmonary lymph node. Frozen section came back as mets so he then removed lymph nodes from stations 8 and 9. He coded the lymphadenectomy as 38746 however that is an add-on code and the primary procedure, 32098, is not one of the primary codes it can be added on to.

Any suggestions on how to report the lymphadenectomy?

thanks!

Shena Betts, CPC
Physician's Professional Mgmt.

 

[helencombs]

38746

as seen here: http://www.sts.org/sites/default/files/documents/pdf/newsletters/Coding/Volume_17_No_1_Coding.pdf

on pg 6, you wouldn't report the removal. not enough to cover the code so it's sampling, which is bundled into the major procedure.

 

[sbetts]

thank you for your reply and the reference!

 

[sbetts]

another question....

if he had removed all the lymph nodes required for a lymphadenectomy, he still would not be able to report 38746 with 32098. How would you report it? Unlisted?

thanks again!