Question: If my urologist does a radical nephrectomy with a retroperitoneal lymph node dissection, does code 50230 include all that or should I report 38780 with 50230?
|Ask an Expert
Got similar questions? Just shoot your questions to SuperCoder’s ‘Ask an Expert’ forum and our experts will get back to you with the answers within 24 business hours.
Click here to buy.
Answer: When your urologist performs a radical nephrectomy and you report 50230 (Nephrectomy, including partial ureterectomy, any open approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy) this coding includes a regional lymph node resection.
If the surgeon performed a more extensive lymph node resection, consider also reporting add-on code +38747 (Abdominal lymphadenectomy, regional, including celiac, gastric, portal, peripancreatic, with or without para-aortic and vena caval nodes [List separately in addition to code for primary procedure]). For you to bill this add-on code, your urologist does not have to resect each and every one of these nodal areas.
Keep in mind: Code 38780 (Retroperitoneal transabdominal lymphadenectomy, extensive, including pelvic, aortic, and renal nodes [separate procedure]) is a complete full bilateral nodal resection as one would do for testicular tumors. It isn’t likely that your urologist performed this sort of extensive bilateral procedure for a renal tumor.
- Free updates on CPT, ICD-9, HCPCS, Medicare, NCCI edits, and ICD-10.
- Discounts on 3rd party offers