It can be argued that the Coder's Desk Reference is more of a guide on how a procedure "could" be done rather than how it "has" to be done. The actual definition of 38746 in CPT does not specify what approach needs to be taken so I use this code whether my physicians perform a thoracotomy, sternotomy, or use a video-assisted thoracoscope.
I'm not sure I have this in writing but the Society of Thoracic Surgeons has also said that this code should be used for mediastinal lymphadenectomy regardless of approach.
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