How To Use CPT Code 38720

CPT 38720 describes the complete cervical lymphadenectomy procedure, which involves the removal of lymph nodes from the cervical area. 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 38720?

CPT 38720 is used to describe the complete cervical lymphadenectomy procedure, which involves the complete removal of lymph nodes from the cervical area or neck. This procedure is typically performed when there is metastatic cancer or other diseases in this area that require the removal of lymph nodes and other tissues.

2. Official Description

The official description of CPT code 38720 is: ‘Cervical lymphadenectomy (complete).’ If the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. The provider prepares the patient and administers anesthesia.
2. The provider adjusts the head and neck of the patient to provide better exposure of the target area.
3. A long incision is made starting under the ear and extending down the neck and out to the chin.
4. The provider identifies the areas of disease and removes the lymph nodes and other tissues involved in or near the area.
5. Hemostasis is ensured to stop any bleeding.
6. The incision is closed in layers.

4. Qualifying circumstances

CPT 38720 is performed when there is a need to completely remove lymph nodes from the cervical area due to metastatic cancer or other diseases. The procedure may also involve the excision of nerves, blood vessels, and additional muscle and soft tissue if they are involved in the disease. It is important to note that complete cervical lymphadenectomy is performed less frequently now, as providers have found that taking less tissue can be as effective in treating and controlling the spread of cancer.

5. When to use CPT code 38720

CPT code 38720 should be used when the provider performs a complete cervical lymphadenectomy procedure, which involves the complete removal of lymph nodes from the cervical area. It should not be used for partial lymphadenectomy procedures or when less tissue removal is sufficient.

6. Documentation requirements

To support a claim for CPT code 38720, the provider must document the following information:

• Patient’s diagnosis and the need for complete cervical lymphadenectomy
• Details of the procedure, including the incision site and the lymph nodes and tissues removed
• Any additional tissues, such as nerves and blood vessels, that were excised
• Confirmation of hemostasis
• Details of the closure of the incision

7. Billing guidelines

When billing for CPT code 38720, ensure that the procedure performed is a complete cervical lymphadenectomy. If the procedure is performed bilaterally, modifier 50 should be appended to the code. It is important to note that CPT code 38720 may bundle into other procedures for the treatment of extensive cancer of the head and neck. If the provider performs a radical neck dissection during the global period of another procedure to remove the actual tumor, modifier 58 may need to be appended to code 38720.

8. Historical information

CPT code 38720 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 in the cervical area undergoes a complete cervical lymphadenectomy to remove all affected lymph nodes.
2. A provider performs a complete cervical lymphadenectomy on a patient with extensive disease in the neck area.
3. A patient with a diagnosis of lymphoma requires a complete cervical lymphadenectomy to remove affected lymph nodes.
4. A provider performs a complete cervical lymphadenectomy on a patient with recurrent cancer in the cervical area.
5. A patient with a diagnosis of melanoma undergoes a complete cervical lymphadenectomy to remove potentially affected lymph nodes.
6. A provider performs a complete cervical lymphadenectomy on a patient with extensive metastatic disease in the neck area.
7. A patient with a diagnosis of head and neck cancer requires a complete cervical lymphadenectomy to remove all affected lymph nodes.
8. A provider performs a complete cervical lymphadenectomy on a patient with a large tumor in the cervical area.
9. A patient with a diagnosis of thyroid cancer undergoes a complete cervical lymphadenectomy to remove potentially affected lymph nodes.
10. A provider performs a complete cervical lymphadenectomy on a patient with extensive lymph node involvement in the neck area.