AAPC - Back to school
Results 1 to 2 of 2

Thread: are 38792 and 38900 actually bundled?

  1. #1

    Default are 38792 and 38900 actually bundled?

    AAPC: Back to School
    I've been coding as if they are, but I can't find anything actually stating that they are. 38900 stipulates that "injection of non-radioactive dye, when performed" is included, but the AMA's notes state that injection of radioactive tracer should be coded with CPT 38792.

    So, if you're doing a sentinel lymph node mapping procedure with injection of a radioactive tracer, why wouldn't we use both codes?

    The Medicare reimbursement (in my area) for CPT code 38792 is only $41.68, while the reimbursement for 38900 is $147.88. It just doesn't make sense to me to use 38792 by itself, but 38900 specifically excludes the radioactive dye.

    Does anyone have documentation stating you can't use both, or has anyone received denials from payers for coding both codes?

  2. #2
    Join Date
    Apr 2007
    JC MO

    Default are 38792 and 38900 actually bundled?

    38900 should be reported by the surgeon performing the sentinel node biopsy when the mapping is performed during the operative session. It is used to report nonradioactive dye being injected into the area of focus.

    38792 is typically performed by an interventional radiologist prior to surgery and is used to report radioactive tracer.

    It would not be appropriate to report both codes for identification of the same sentinel node.

Similar Threads

  1. The Difference between 38900 & 38792
    By Mklaubauf in forum General Surgery
    Replies: 6
    Last Post: 01-23-2016, 09:00 PM
  2. 30465 & 30520 Bundled or No longer Bundled
    By Rip in forum Billing/Reimbursement
    Replies: 0
    Last Post: 10-05-2012, 02:18 PM
  3. Is the dye billable? 38900?
    By jk2003 in forum Plastic Surgery
    Replies: 2
    Last Post: 06-10-2011, 08:42 AM
  4. 38792 vs 38900
    By ksb0211 in forum General Surgery
    Replies: 2
    Last Post: 05-24-2011, 08:14 AM
  5. Who gets to bill the 38792?
    By HILLIC in forum General Surgery
    Replies: 6
    Last Post: 01-08-2009, 09:41 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.