Results 1 to 3 of 3

Please help with coding Modified Radical Mastectomy

  1. #1
    Default Please help with coding Modified Radical Mastectomy
    Medical Coding Books
    Hi Just wondering if I could get some help coding
    the following Lt Modified radical Mastectomy with Lt sentinal lymph node bx x 2
    I was looking at the 19307, 38500 and 38792 however the 38500 is bundled and CCI states that I could use a modifier just not sure how to do this. Would I use the 58 modifier as the 59 is separate and distinct PLEASE HELP
    TIA Deb,CPC

  2. #2
    Kansas City, MO
    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.

  3. #3
    Thanks so much for your response. It really has helped me out.
    Deb, CPC

Similar Threads

  1. skin sparing modified radical mastectomy
    By margaretl in forum General Surgery
    Replies: 1
    Last Post: 04-24-2013, 10:07 AM
  2. Modified Radical neck with Laryngectomy
    By kenbeckman in forum ENT/Otolaryngology
    Replies: 1
    Last Post: 03-05-2013, 12:08 PM
  3. modified radical adominal hysterectomy
    By Bamatide in forum OB/GYN
    Replies: 0
    Last Post: 04-14-2011, 08:54 AM
  4. Modified Radical Mast
    By Hopp in forum General Surgery
    Replies: 1
    Last Post: 02-13-2010, 07:57 AM
  5. Need help coding Modified Radical Mastectomy
    By Hopp in forum General Surgery
    Replies: 0
    Last Post: 01-28-2010, 12:16 PM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.