Our office also does the 19301 in conjunction with the 38525 and 38792 for our WLE with sentinel lymph node biopsy and injection for identification of the sentinel node. We have not been denied billing it this way. We were originally billing the 19302, but I found a very good article in The Journal of Family Practice about the right way to bill for sentinel nodes. it states:
Originally Posted by mizzmaryb
ANSWER: The American College of Surgeons and Medicare addressed this coding scenario. CPT code 19302 describes a partial mastectomy-a lumpectomy, tylectomy, quadrantectomy or segmentectomy with axillary lymphadenectomy.
For Partial mastectomy (CPT 19301) with sentinal lymph node biopsy (typically CPT code 38525) and dye injection to identify the sentinel node (CPT code 38792) the surgeon would use these CPT codes to report the service.
*38792 (a modifier 51 exempt code)
There reasoning behind this being "bundling this procedure into CPT code 19302, which describes an axillary lympadenectomy, is incorrect. That is not what the surgeon performed. While the facility may feel the reimbursement is better by reporting 19302, the physician must accurately report the CPT codes to describe the procedure regardless of reimbursement"
RBoggs CMA, CGSC **Bloom where you are planted**