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Thread: Total mastectomy & sentinel node evaluation

  1. #1

    Default Total mastectomy & sentinel node evaluation

    AAPC: Back to School
    I am receiving conflicting coding information on the following procedure so I would like some input:

    Via transverse incision, the sentinel node was removed & sent off to pathology. Other additional nodes that were enlarged were also removed. Attention towards breast, including the nipple-areolar complex, the flaps were raised superior to the clavicle, inferior to rectus abdominis, medial to the sternum, lateral to latissimus dorsi, & the breast was taken superior to inferior and medial to lateral pattern with care to take to pectoralis fascia in continuity; sent to pathology. I think 19307 ?? thank you

  2. #2
    Join Date
    Apr 2007
    Vancouver Washington


    This doesn't sound like a radical mastectomy. I would query your doc. Did he/she make 2 incisions? One in the axilla and one on the breast? Did he inject dye to locate the sentinel node? I would be looking at 38500 (can only use 38525 if the doc hits level 2 or lower. Regarding the mastectomy, I would look at 19303 maybe? Just my thoughts
    Jaime Wicklund, CPC

  3. #3


    1 incision was made in the axillary & 1 incision into the breast. No documentation on the depth of the axillary nodes.

  4. #4
    Join Date
    Apr 2007
    Vancouver Washington


    then I would code 19303 and 38500. (query the physician about injecting dye intraoperatively.. if so then 38792 as well)
    Jaime Wicklund, CPC

  5. #5

    Default Total Mastectomy & Sent.Lymph node eval

    I thought that the Mastectomy codes 19303 thru 19307 included the
    sentinel lymph nodes and you could not bill separately for that. I am still
    new at coding myself so thats why I am questioning this because I had
    put a similar ? out re: Mastectomy, Sent.Lymph nodes bx and Inj.of dye
    and what I could and couldnt code for. ? being Can I bill a Mastectomy
    code with Sent.Lymph node bx and dye injection. Please Help!
    Deb, CPC

  6. #6


    After the dye has been injected and the physician uses the gamma probe to find the node/s you should be able to use 38308 for the mapping also. We do and do not have a problem getting reimbursement for this.dd

  7. #7

    Default Total Mastectomy & Sent.lymph node eval

    I would use the 38525 for the sent.lymph node eval (As this states axilla).
    Just what I had been told to use along with Mastectomy.
    Deb, CPC

  8. #8


    i am almost a year late behind on this....can someone please help me with my question i have posted? it's regarding 19303 vs 19307 as well.

    this is very confusing to me and i'm still quite new to breast surgery coding.

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