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LAVH w/Laparoscopic Lymphadenectomy

  1. #1
    Kansas City, MO
    Question LAVH w/Laparoscopic Lymphadenectomy
    Medical Coding Books
    I am reviewing a surgery for one of our providers that was denied. The codes billed out by the office are,

    58552 and 38770-51

    Now, in looking at the note, the lymphadenectomy was done laparoscopicly as well. Based on the Coders Desk Reference the 38770 is not a laparoscopic procedure. I have looked at the codes in the 38570-38589 range and this is what the surgeon did:

    The left external, internal, and obturator lymph nodes were removed, as a single specimen will be labeled as left pelvic lymph node similarly on the right side. Then it describes the removal and then they desufflated the pressure to 7 to check for bleeding. . .

    None of the nodes were biopsied, they were simply removed. This is not my strong area and none of these codes seem to be a good fit. What would you do?

    Angela Jordan, CPC, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013

  2. #2
    if the procedure is via laparoscopy you should use 38571 or 38572, if they were removed there should be specified in the pathology reporting as well.
    Hope this helps
    L.Ivonne Garcia CPC

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