How To Use CPT Code 38724

CPT 38724 describes the procedure known as cervical lymphadenectomy, specifically a modified radical neck dissection. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 38724?

CPT 38724 is used to report the surgical procedure known as cervical lymphadenectomy, specifically a modified radical neck dissection. This procedure involves the excision of lymph nodes and any diseased soft tissue in the cervical area. The provider takes care to dissect and preserve important structures such as the spinal accessory nerve, jugular vein, and sternocleidomastoid muscle. The goal of this procedure is to remove diseased lymph nodes and prevent the further spread of extensive disease.

2. Official Description

The official description of CPT code 38724 is: ‘Cervical lymphadenectomy (modified radical neck dissection).’ There are no additional notes or modifiers specified for this code.

3. Procedure

1. The patient is appropriately prepped and anesthetized, and the provider adjusts the head and neck to provide better exposure of the target area.
2. A long incision is made starting under the ear and extending down the neck and out to the chin.
3. The provider identifies the areas of disease and carefully excises the lymph nodes and any other tissues involved in or near the area of disease.
4. Special attention is given to dissecting and preserving the spinal accessory nerve, jugular vein, and sternocleidomastoid muscle.
5. The provider reapproximates the tissues and closes the incision in layers.

4. Qualifying circumstances

CPT 38724 is performed on patients who require the excision of lymph nodes and additional soft tissue in the cervical area. This procedure is typically done to treat extensive cancer of the head and neck. The provider must take extra care to dissect and preserve important structures such as the spinal accessory nerve, jugular vein, and sternocleidomastoid muscle. The specific qualifying circumstances may vary depending on the patient’s condition and the provider’s clinical judgment.

5. When to use CPT code 38724

CPT code 38724 should be used when a modified radical neck dissection is performed to excise lymph nodes and additional soft tissue in the cervical area. This code is appropriate for reporting the procedure when it is performed as a standalone procedure or as part of the treatment for extensive cancer of the head and neck. It should not be used for other types of neck dissections or lymphadenectomies.

6. Documentation requirements

To support a claim for CPT code 38724, the provider must document the following information:

• Patient’s diagnosis and the need for cervical lymphadenectomy
• Details of the procedure performed, including the excision of lymph nodes and any additional soft tissue
• Description of the structures dissected and preserved, such as the spinal accessory nerve, jugular vein, and sternocleidomastoid muscle
• Date of the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 38724, ensure that the procedure performed meets the criteria for a modified radical neck dissection. This code should not be reported if the procedure performed is a different type of neck dissection or lymphadenectomy. It is important to review the documentation and clinical notes to accurately report the procedure. Modifier 58, Staged or related procedure or service by the same physician during the postoperative period, may be appended if the provider performs the modified radical neck dissection during the global period of another procedure to remove the actual tumor.

8. Historical information

CPT code 38724 was added to the Current Procedural Terminology system on January 1, 1990. The only historical change noted is that it was added under the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient with extensive cancer of the head and neck undergoes a modified radical neck dissection to remove diseased lymph nodes and preserve important structures.
2. A provider performs a modified radical neck dissection as part of the treatment for a patient with advanced thyroid cancer.
3. A patient with metastatic squamous cell carcinoma of the neck undergoes a modified radical neck dissection to remove affected lymph nodes and prevent further spread of the disease.
4. A provider performs a modified radical neck dissection on a patient with recurrent lymphoma in the cervical area.
5. A patient with extensive melanoma in the head and neck region undergoes a modified radical neck dissection to remove affected lymph nodes and prevent the spread of the disease.
6. A provider performs a modified radical neck dissection on a patient with extensive cancer of the salivary glands in the cervical area.
7. A patient with advanced oral cavity cancer undergoes a modified radical neck dissection to remove affected lymph nodes and prevent further spread of the disease.
8. A provider performs a modified radical neck dissection on a patient with recurrent metastatic carcinoma in the cervical area.
9. A patient with extensive sarcoma in the head and neck region undergoes a modified radical neck dissection to remove affected lymph nodes and prevent the spread of the disease.
10. A provider performs a modified radical neck dissection on a patient with extensive cancer of the parotid gland in the cervical area.