2025 CPT code 38792
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Hemic and Lymphatic Systems Feed
Injection procedure for identification of sentinel node using a radioactive tracer.
Modifier 51 can be used to indicate multiple procedures, for example, if injection of the radioactive tracer is performed at multiple sites. Modifier 59 is permitted when performed as a distinct procedural service from blue dye injection (38900).
Medical necessity is established by the need to determine whether a cancer has spread to the lymphatic system. This information is crucial for staging the cancer and planning appropriate treatment. Sentinel lymph node biopsy is considered the standard of care for regional lymph node staging in melanoma and breast cancer, and the injection of a radioactive tracer is necessary for identifying the sentinel node(s).
Typically performed by a surgeon or a radiologist. It involves injecting the radioactive tracer around the tumor site and potentially massaging the area to facilitate lymphatic drainage. Requires knowledge of lymphatic anatomy and proper injection techniques.
In simple words: A radioactive dye is injected near the tumor site. This dye travels to the lymph nodes. The first lymph node the dye reaches is called the sentinel node. Identifying this node helps doctors determine if the cancer has spread. The injection is typically given some time before the surgery to remove the tumor and the sentinel node.
This code represents the injection of a radioactive tracer material for the purpose of identifying the sentinel lymph node(s). This procedure is often performed prior to surgery for melanoma or breast cancer. The tracer is injected into the tissues surrounding the primary tumor site, and it travels through the lymphatic system to the sentinel node(s), which are the first node(s) to receive lymphatic drainage from the tumor.This procedure assists in the subsequent localization and biopsy or excision of the sentinel node(s). It is important to note that this code does not include the actual removal of the sentinel node(s); separate codes (e.g., 38500-38542) are used for the excision/biopsy.This code also differs from 38900 (injection of non-radioactive dye) and 78195 (nuclear medicine lymphatics and lymph gland imaging with scintigraphy).
Example 1: A patient diagnosed with melanoma on the arm undergoes injection of a radioactive tracer for sentinel lymph node identification prior to surgical excision of the melanoma., A patient diagnosed with breast cancer undergoes injection of a radioactive tracer for sentinel lymph node identification prior to a lumpectomy., A patient with a suspicious lesion on the leg receives an injection of a radioactive tracer to identify the sentinel lymph node. This helps determine if the lesion has spread to the lymphatic system.
Documentation should include the type and dose of radioactive tracer used, the injection site(s), and any relevant clinical findings or observations. It should clearly state the purpose of the injection (i.e., sentinel lymph node identification), and link it to the planned surgical procedure.
- Payment Status: Active
- Specialties:Surgery (General Surgery, Surgical Oncology, Breast Surgery), Radiology (Nuclear Medicine), Dermatology
- Place of Service:Office, Inpatient Hospital, Outpatient Hospital, Ambulatory Surgical Center, Independent Clinic