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The individuals who appear are for illustrative purposes. All persons depicted are models and not real healthcare professionals. US-N/A-2400043 05/24

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Coding for RP used for sentinel node localization with a lymphangiogram

Q.

We performed a sentinel node localization on a patient. We injected the radiopharmaceutical, did a lymphangiogram, then sent the patient to surgery. We reported CPT® codes 78195 and 38792 but are getting denied. Do you know what the problem is? 

A.

Yes, code 38792 is reported only when you inject the radiopharmaceutical for sentinel node localization and send the patient to surgery without doing a diagnostic lymphangiogram. If images are taken, then code 78195 is reported and includes the injection. You cannot report both codes together. The code and full description are as follows:

38792  Injection procedure; radioactive tracer for identification of sentinel node

78195 Lymphatics and lymph nodes imaging