How To Use CPT Code 38700

CPT 38700 describes the procedure of suprahyoid lymphadenectomy, which involves the excision of lymph nodes from the top of the hyoid bone. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38700?

CPT 38700 is used to describe the surgical procedure known as suprahyoid lymphadenectomy. This procedure involves the removal of lymph nodes located above the hyoid bone, which is a small bone in the midline near the base of the tongue and above the thyroid gland. In cases of metastatic cancer, additional tissue in the area of the jaw and upper neck may also be removed.

2. Official Description

The official description of CPT code 38700 is: ‘Suprahyoid lymphadenectomy, including removal of submandibular gland and other tissue in the area of the jaw and upper neck.’

3. Procedure

1. The patient is appropriately prepped and anesthetized.
2. The healthcare provider adjusts the head and neck of the patient to improve access to the target area.
3. An incision is made starting just below the ear and curving to the top of the hyoid bone.
4. The incision is extended towards the chin.
5. The healthcare provider takes care to preserve critical nerves, blood vessels, and other structures in the area.
6. The submandibular gland is identified and removed.
7. The submental and submandibular lymph nodes are removed.
8. The tissues in the area are inspected for evidence of disease, and any suspicious tissue is removed.
9. Hemostasis is ensured.
10. The incision is closed in layers, and a drain may be placed.

4. Qualifying circumstances

CPT 38700 is performed on patients with conditions that require the removal of lymph nodes located above the hyoid bone. This procedure is commonly performed in cases of metastatic cancer. It is important to note that for a bilateral procedure, modifier 50 should be appended to the code.

5. When to use CPT code 38700

CPT code 38700 should be used when a suprahyoid lymphadenectomy is performed, including the removal of the submandibular gland and other tissue in the area of the jaw and upper neck. It is important to ensure that the procedure is documented accurately and meets the criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 38700, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for suprahyoid lymphadenectomy
• Details of the procedure performed, including the removal of the submandibular gland and other tissue in the area of the jaw and upper neck
• Date of the procedure
• Any additional findings or procedures performed during the surgery
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 38700, ensure that the procedure meets the criteria outlined in the official description. Modifier 50 should be appended to the code for a bilateral procedure. It is important to review any bundling or unbundling guidelines specific to the payer to ensure accurate billing.

8. Historical information

CPT 38700 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A patient with metastatic cancer undergoes suprahyoid lymphadenectomy, including the removal of submandibular gland and other tissue in the area of the jaw and upper neck.
2. A healthcare provider performs a bilateral suprahyoid lymphadenectomy, including the removal of submandibular gland and other tissue in the area of the jaw and upper neck, on a patient with recurrent disease.
3. During a planned staged procedure, a suprahyoid lymphadenectomy, including the removal of submandibular gland and other tissue in the area of the jaw and upper neck, is performed by a healthcare provider.
4. A patient with advancing disease undergoes suprahyoid lymphadenectomy, including the removal of submandibular gland and other tissue in the area of the jaw and upper neck.
5. A healthcare provider performs a suprahyoid lymphadenectomy, including the removal of submandibular gland and other tissue in the area of the jaw and upper neck, as a separate procedure for a patient with a specific diagnosis.