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Theresa Posted Wed 27th of December, 2017 13:26:00 PM
WHAT CPT CODES SHOULD I USE FOR "BILATERAL ROBOTIC NERVE SPARING RPLND (RETROPERITONEAL LYMPH NODE DISSECTION)" PHYSICIAN IS USING DIAGNOSIS C62.91 (MALIGNANT NEO TESTIS). PT HAS HAD A RIGHT RADICAL ORCHIECTOMY PRIOR TO THIS PROCEDURE. 2 WEEKS AFTER ORCHIECTOMY CT SCAN SHOWED PROMINENT NODES THAT ARE CONCERNING FOR METASTATIC DISEASE.
SuperCoder Answered Thu 28th of December, 2017 01:51:44 AM

HELLO

As per above scenario, CPT code 38589 {Unlisted laparoscopy procedure, lymphatic system} seems to be the appropriate code. When reporting a procedure with an unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes, and compare your service to those codes to justify the claim amount you are billing. Also include the operative notes or other relevant documentation to strengthen the claim and to avoid a possible denial. Your payers will consider claims with unlisted procedure codes on a case by case basis, and they will determine payment based on the documentation you provide.

If this procedure is performed by the same physician as radical orchiectomy, then you may also add modifier-79 {Unrelated procedure or service by the same physician during the postoperative period} to your CPT code.

HOPE THIS HELPS!

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