How To Use CPT Code 38573

CPT code 38573 describes a laparoscopic surgical procedure that involves the removal of lymph nodes in the pelvic area, along with sampling of lymph nodes in the aortic area, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings. This article will provide an overview of CPT code 38573, including its official description, the procedure involved, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 38573?

CPT 38573 is a code used to describe a laparoscopic surgical procedure that includes the removal of lymph nodes in the pelvic area, sampling of lymph nodes in the aortic area, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings. This procedure is performed to remove any diseased lymph nodes and prevent the spread of cancer.

2. Official Description

The official description of CPT code 38573 is: ‘Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed.’

3. Procedure

1. The laparoscopic procedure begins with the provider making small incisions, including one at the umbilicus, to insert a laparoscope and other instruments into the abdomen.
2. The provider insufflates the abdomen with a gas, such as carbon dioxide, to create space and improve visualization.
3. Any adhesions present in the abdomen are removed, and the provider uses suction to clear the area of blood and clots.
4. The provider then proceeds to remove all lymph nodes in the pelvic area on both sides.
5. Next, the provider samples lymph nodes in the aortic area and sends them to the laboratory for examination.
6. The peritoneal cavity is thoroughly examined for any signs of cancer spread, and peritoneal washings are performed.
7. If necessary, the provider may also perform peritoneal biopsies and omentectomy.
8. The diaphragm is washed, and biopsies of the diaphragm and other serosal tissues may be taken.
9. The provider ensures hemostasis and closes the small incisions.

4. Qualifying circumstances

CPT code 38573 is used for patients who require the removal of lymph nodes in the pelvic area, along with sampling of lymph nodes in the aortic area, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings. This procedure is typically performed to prevent the spread of cancer. It is important to note that CPT code 38573 should not be reported in conjunction with certain other codes, as specified in the notes.

5. When to use CPT code 38573

CPT code 38573 should be used when a laparoscopic surgical procedure is performed to remove lymph nodes in the pelvic area, sample lymph nodes in the aortic area, perform peritoneal washings and biopsies, omentectomy, and diaphragmatic washings. It is important to review the specific documentation and indications for this procedure to determine if CPT code 38573 is appropriate.

6. Documentation requirements

To support a claim for CPT code 38573, the provider must document the following information:

• Indication for the procedure and the need for lymph node removal
• Details of the laparoscopic surgical procedure performed, including the specific areas targeted and any additional procedures such as peritoneal washings, biopsies, omentectomy, and diaphragmatic washings
• Date of the procedure and the duration of the surgery
• Any complications or unexpected findings during the procedure
• Pathology reports or results of any laboratory examinations
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 38573, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, CPT code 38573 should not be reported in conjunction with certain other codes, as specified in the notes. It is recommended to review the specific billing guidelines and requirements of the payer to ensure accurate and appropriate reporting of CPT code 38573.

8. Historical information

CPT code 38573 was added to the Current Procedural Terminology system on January 1, 2018. There have been no updates or changes to the code since its addition.

9. Similar codes to CPT code 38573

Five similar codes to CPT code 38573 include:

• CPT 38570: Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy
• CPT 38571: Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and sampling of para-aortic lymph nodes
• CPT 38572: Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and sampling of para-aortic, common iliac, or external iliac lymph nodes
• CPT 38589: Unlisted laparoscopy procedure, lymphatic system and related structures
• CPT 38770: Lymphadenectomy, retroperitoneal; open, including iliac, obturator, and/or hypogastric nodes

9. Examples

1. A patient with suspected ovarian cancer undergoes a laparoscopic procedure with bilateral total pelvic lymphadenectomy, peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings.
2. A patient with endometrial cancer requires a laparoscopic procedure with bilateral total pelvic lymphadenectomy, peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings.
3. A patient with testicular cancer undergoes a laparoscopic procedure with bilateral total pelvic lymphadenectomy, peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings.
4. A patient with cervical cancer requires a laparoscopic procedure with bilateral total pelvic lymphadenectomy, peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsies, omentectomy, and diaphragmatic washings.