19307 includes the taking of the lymph nodes.
IF this is a RARE situation where you did the sentinal node bx, and then do to results of that your surgeon decided to do the MRM, then you could try to bill using the -58 on the 19307, since it was done as a result of the first procedure. prepare for a fight on this one. The ins co will try to bundle, so you may have to appeal, but I have had luck winning on this with a written appeal. The op should really support that the pt was there for LN bx, and that after this a decision had to be made to do a more extensive procedure.
MOST procedures will not meet this criteria...and like I said, the LN's are inclusive of the MRM.
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