Becky Posted Mon 12th of December, 2016 10:07:45 AM
My doctor performed the following surgery. What are the appropriate codes to use?
Lesion measured approximately 2 x 2 centimeters and was on the right labium minus. Radiotracer probe was utilized to isolate approximate location of the sentinel nodes and a 3 cm incision was made paralleling the inguinal ligament overlying this area. Subcutaneous layers were separated. Scarpa fascia was incised and separated and the radiotracer probe utilized to further localize the lymph nodes. Bovie electrosurgery was utilized as needed to dissect out the lymph nodes. Sentinel lymph node #1 recorded 1250 at the 1000 setting and sentinel lymph node #2 recorded 3400 at the 1000 setting. Both nodes were hot and blue. Background was approximately 20 to 1000 setting following resection of the nodes. A drain was placed and secured with nylon stitch. Scarpa's fascia was reapproximated with 3-0 Vicryl and the skin was closed with 4-0 Monocryl.
Attention was then turned to the vulva. The lesion was on the right labium minus and approximately 1 centimeter from the clitoral hood. In this area, 1 centimeter margin was chosen and other areas 1.5 to 2 centimeters margin, an elliptical incision was made. Subcutaneous layers were taken down to the underlying fascia consistent with the radical vulvectomy. Bovie electrosurgery was utilized with 3-0 Vicryl stitches as needed for hemostasis. Specimen was removed and pinned on Styrofoam for anatomic Pathology assessment.The area was then copiously irrigated, hemostasis noted throughout, and the lesion was closed with 3-0 Vicryl mattress stitches. V-Y skin advancement was utilized to reconstruct the clitoral hood.
SuperCoder Answered Tue 13th of December, 2016 01:17:30 AM
Becky Posted Tue 13th of December, 2016 06:14:19 AM
My dr. performed the following:
1. Bilateral inguinal sentinel node dissection.
2. Radical posterior hemivulvectomy.
3. Bilateral rhomboid rotation flap closure.
Do these codes look good? 56630 38500 38900 14040
SuperCoder Answered Wed 14th of December, 2016 06:12:22 AM
As per the provided documentation, CPT codes for above mentioned procedures are as below:
For Bilateral inguinal sentinel node dissection: 38500-50 (50 modifier for bilateral procedure) and 38900
For Radical posterior hemivulvectomy: 56630
For Bilateral rhomboid rotation flap closure: 14040