How To Use CPT Code 38570

CPT 38570 describes the laparoscopic procedure of sampling one or more lymph nodes in the retroperitoneum for staging cancer. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38570?

CPT 38570 is used to describe a laparoscopic procedure in which the provider samples one or more lymph nodes in the retroperitoneum. This procedure is performed to stage cancer in the retroperitoneum and adjacent areas. It involves making small incisions and inserting a laparoscope, or camera, along with tools to sample the lymph nodes.

2. Official Description

The official description of CPT code 38570 is: ‘Laparoscopy, surgical; with retroperitoneal lymph node sampling (biopsy), single or multiple.’

3. Procedure

1. The provider begins by making small incisions, including one at the umbilicus, or navel, to insert the laparoscope and insufflate gas into the abdomen for better visualization.
2. Additional small incisions are made to insert instruments for the procedure.
3. The provider explores the abdomen for indications of cancer in the retroperitoneum and excises the lymph nodes in this area.
4. The samples are sent to pathology for examination to determine the presence of metastatic cancer and the stage of the disease.
5. In cases of extensive metastatic cancer, the provider may need to sample lymph nodes in adjacent areas to assess the extent of the disease.
6. Hemostasis is achieved, and the small incisions are closed in layers.

4. Qualifying circumstances

CPT 38570 is performed when there is a need to stage cancer in the retroperitoneum and adjacent areas. The procedure involves sampling lymph nodes in the retroperitoneum. It is typically performed laparoscopically by a qualified provider. The patient must meet the criteria for the procedure, such as having a suspected or confirmed diagnosis of cancer in the retroperitoneum.

5. When to use CPT code 38570

CPT code 38570 should be used when a laparoscopic procedure is performed to sample one or more lymph nodes in the retroperitoneum for staging cancer. It is important to ensure that the procedure meets the specific criteria outlined in the code description. If the procedure involves more extensive lymphadenectomy or lymph node sampling, other codes should be used.

6. Documentation requirements

To support a claim for CPT 38570, the provider must document the following information:

• Indication for the procedure, such as suspected or confirmed cancer in the retroperitoneum
• Details of the laparoscopic procedure, including the number of lymph nodes sampled
• Pathology results indicating the presence of metastatic cancer and the stage of the disease
• Any additional procedures performed, such as sampling lymph nodes in adjacent areas
• Details of hemostasis achieved and closure of incisions

7. Billing guidelines

When billing for CPT 38570, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the procedure and provide supporting documentation, such as pathology results. CPT code 38570 should not be reported with other codes for more extensive lymphadenectomy or lymph node sampling procedures. Additional tips and guidelines for reporting CPT 38570 can be found in the official coding resources.

8. Historical information

CPT 38570 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a laparoscopic procedure to sample lymph nodes in the retroperitoneum of a patient with suspected cancer in that area.
2. During a laparoscopic procedure, a provider samples multiple lymph nodes in the retroperitoneum to stage metastatic cancer.
3. A patient with confirmed cancer in the retroperitoneum undergoes a laparoscopic procedure for lymph node sampling.
4. A provider performs a laparoscopic procedure to sample lymph nodes in the retroperitoneum and adjacent areas to assess the extent of metastatic cancer.
5. During a laparoscopic procedure, a provider samples a single lymph node in the retroperitoneum for staging purposes.
6. A patient with suspected cancer in the retroperitoneum undergoes a laparoscopic procedure for lymph node sampling to determine the stage of the disease.
7. A provider performs a laparoscopic procedure to sample lymph nodes in the retroperitoneum and sends the samples to pathology for examination.
8. During a laparoscopic procedure, a provider samples multiple lymph nodes in the retroperitoneum and adjacent areas to assess the spread of cancer.
9. A patient with confirmed cancer in the retroperitoneum undergoes a laparoscopic procedure for lymph node sampling to guide treatment decisions.
10. A provider performs a laparoscopic procedure to sample lymph nodes in the retroperitoneum and achieves hemostasis before closing the incisions.