mardi 1 septembre 2015

Sentinel node biopsy again!!

Hiiii.......

if Sentinel node biopsy was done, and the surgeon decided to go for axillary lymphadenectomy ...

should i code both axillary lymph node biopsy and excision? or only excision?

what i knew is i only code excision, but found this in super coder:

Tip 1: If Biopsy Results Lead to Subsequent Excisions, Biopsy Is Billable When the surgeon performs a sentinel node biopsy prior to an unplanned partial mastectomy (either with or without lymphadenectomy) -- and the subsequent excisions are a result of biopsy findings -- you may report the sentinel node biopsy separately. CMS goes on record: "Sentinel lymph node biopsy is separately reported when performed prior to a localized excision of breast or a mastectomy without lymphadenectomy," according to guidelines set forth in Chapter 3 of the National Correct Coding Initiative Policy Manual for Medicare Services.

In simple language: You can report both sentinel lymph node biopsy and lymphadenectomy during the same session as long as: The lymphadenectomy is unplanned at the time of the biopsy The decision to perform lymphadenectomy (at the same or a later session) is based on the results of the biopsy.

Example: The surgeon takes a biopsy of the sentinel axillary node (38525, Biopsy or excision of lymph node[s]; open, deep axillary node[s]). The pathology report indicates that the malignancy has spread, so the surgeon follows up with a lymphadenectomy (for example, 38745, Axillary lymphadenectomy; complete) to remove the affected tissue. In this case, because the biopsy led to the decision to perform the mastectomy, you may report both 38525 and 38745. - See more at:
http://ift.tt/1EvsdpU

http://ift.tt/1Q69Xol



then i found this article:
http://ift.tt/1Q69Xoo


When a total mastectomy with sentinel node biopsy is performed, I obtain a frozen section of the nodes and proceed to dissect the axilla if positive. Can I use multiple codes for this procedure?

This is a modified radical mastectomy (19307) with sentinel node mapping procedure (38900). The axillary node biopsy cannot be reported separately from the axillary dissection.is this correct?

i am confused ...

which is correct ?


Sentinel node biopsy again!!

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