Sentinel Node Identification

Question:

We have a new plastic surgeon and he’s doing a procedure my other guys don’t perform.  The patient goes to radiology for injection of radioactive isotopes then to the operating room where my plastic surgeon excises the skin cancer and then injects blue dye and uses a gamma probe to identify a sentinel node.  Then he excises the sentinel node.  I’ve never coded lymph node procedures before – help!

Answer:

It’s always fun to learn something new, isn’t it!  For the lymph node removal procedure, look at codes 38500 – 38531 to see which code best matches the procedure he did.  Then you can also report +38900 (Intraoperative identification (eg, mapping) of sentinel lymph node(s) includes injection of non-radioactive dye, when performed (List separately in addition to code for primary procedure)). CPT +38900 covers the intraoperative injection and use of the gamma probe to identify the sentinel lymph node.

*This response is based on the best information available as of 3/28/19.