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Mastectomy with sentinel lymph node

  1. Default Mastectomy with sentinel lymph node
    Medical Coding Books
    Can someone tell me if a sentinel lymph node bx is bundled with the mastectomy or is it a separate payment?. It is the same incision site, do I code it separate with a 59?

  2. #2
    Letisha, it depends on the planned procedure.

    Example of when to bill both: The planned procedure was mastectomy, partial, SLN bx returns from pathology as malignant. (Results changed the planned procedure to mastectomy w/axilllary lymphadenectomy).
    Remember to append 59 modifier to SLN Bx.

    Example of when NOT to bill SLN Bx w/ Mastectomy: The planned procedure was mastectomy w/axillary lymphadenectomy, SLN bx results are malignant. (Results did not change planned procedure).
    Hopes this helps?
    Evangelina Frohna, CPC, CEMC

  3. Default Masectomy Reply
    Thank you Evangelina. The information you gave has been really helpful. Thanks!

  4. Default
    It is coded separately when the mastectomy is partial or simple, and ONLY the sentinel node(s) removed.
    C.Martin, CPC-GENSG

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