2025 CPT code 38571
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Hemic and Lymphatic Systems Surgery Feed
Laparoscopic surgical bilateral total pelvic lymphadenectomy.
Modifiers -52 (reduced services) and -58 (staged or related procedure) may be applicable depending on specific circumstances.Modifier -50 (bilateral procedure) should not be used.
Medical necessity for 38571 is established when there is a clinical indication for the removal of pelvic lymph nodes, such as suspected or confirmed malignancy.Documentation should clearly support the presence of cancer or other conditions necessitating the procedure.
The surgeon is responsible for all aspects of the procedure, from patient preparation and anesthesia to incision, lymph node dissection, hemostasis, and closure. This may include managing any complications that arise during or after the procedure.
In simple words: The doctor makes small cuts in the abdomen and inserts a tiny camera to see the lymph nodes.They then remove all the lymph nodes on both sides of the pelvis to prevent cancer from spreading.
This procedure involves a laparoscopic approach to surgically remove all lymph nodes from both sides of the pelvis.It's used to remove diseased lymph nodes and prevent cancer spread. The procedure includes prepping the patient, creating small incisions, insufflating the abdomen with CO2 for better visualization, removing adhesions if present, evacuating blood clots, exploring the pelvic area, excising all pelvic lymph nodes, achieving hemostasis, and closing the incisions.The extent of lymph node removal depends on the cancer's severity; in cases of extensive metastatic disease, all lymph nodes in the affected area might be removed.
Example 1: A 55-year-old female patient with stage II endometrial cancer undergoes a total abdominal hysterectomy with bilateral salpingo-oophorectomy and laparoscopic bilateral total pelvic lymphadenectomy to remove cancerous lymph nodes and prevent metastasis., A 62-year-old male patient with rectal cancer undergoes a laparoscopic low anterior resection with laparoscopic bilateral total pelvic lymphadenectomy to clear the pelvic lymph nodes., A 48-year-old female patient with recurrent ovarian cancer undergoes a laparoscopic cytoreductive surgery with laparoscopic bilateral total pelvic lymphadenectomy to remove residual tumor and affected lymph nodes, as well as assess the extent of disease.
Preoperative diagnosis, operative report detailing the extent of lymphadenectomy (number of nodes removed, location), pathology report confirming the presence or absence of malignancy in the excised lymph nodes, postoperative recovery notes, and any complications encountered.
** Accurate coding requires detailed documentation of the procedure performed.The extent of lymphadenectomy should be specified in the operative report.Always review payer-specific guidelines to ensure proper reimbursement.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: 19.23 RVUs (based on Medicare rate of roughly $692.27 in 2021). Note that this value may vary by payer and location.
- Global Days: The global period for this procedure would depend on the specific payer and may vary.Additional information should be obtained from the payer's guidelines.
- Payment Status: Active
- Modifier TC rule: This code does not typically require a Technical Component (TC) modifier, as it represents the entire procedure.
- Fee Schedule: Fee schedules vary by payer and location.Historical data should be obtained from specific payer resources.
- Specialties:Gynecologic Oncology, Surgical Oncology, Colorectal Surgery
- Place of Service:Ambulatory Surgical Center, Hospital Inpatient, Hospital Outpatient