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2025 CPT code 38572

Laparoscopic surgical procedure involving bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling.

Always use the most specific code that accurately reflects the procedure performed.Surgical laparoscopy always includes diagnostic laparoscopy; use 49320 to report a separate diagnostic laparoscopy.

Modifiers 50, 51, 52, and 58 may be applicable depending on the specific circumstances of the procedure.

Medical necessity for 38572 is established when there is clinical suspicion of malignancy, and the removal and pathological evaluation of the pelvic and peri-aortic lymph nodes are required for proper staging, prognosis, and treatment planning. This can include cases of endometrial, cervical, ovarian, or other pelvic malignancies.

The surgeon is responsible for performing the laparoscopic procedure, including creating incisions, insufflating the abdomen, visualizing the lymph nodes, performing the lymphadenectomy, obtaining tissue samples, and ensuring hemostasis before closing the incisions.Postoperative care falls under the global period rules. The pathologist is responsible for examining the excised lymph nodes.

IMPORTANT:38571 (bilateral total pelvic lymphadenectomy only), 38573 (more extensive procedure including peritoneal washings, peritoneal biopsy, omentectomy, and diaphragmatic washings).

In simple words: The doctor makes small cuts in the abdomen and inserts a tiny camera to view the lymph nodes.They remove all the lymph nodes from both sides of the pelvis and take samples from lymph nodes near the aorta. This helps prevent cancer from spreading.

This laparoscopic procedure entails the complete excision of lymph nodes from both sides of the pelvis (bilateral total pelvic lymphadenectomy) and the sampling (biopsy) of lymph nodes in the peri-aortic region.The procedure involves creating small incisions, insufflating the abdomen with CO2 for visualization, and using a laparoscope and instruments to remove the specified lymph nodes.The excised lymph nodes are sent for pathological examination. This procedure aims to remove cancerous lymph nodes and prevent further spread of the disease.

Example 1: A patient with suspected endometrial cancer undergoes a laparoscopic hysterectomy and bilateral salpingo-oophorectomy.During the procedure, the surgeon performs a bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy) to assess lymph node involvement., A patient with ovarian cancer undergoes a laparoscopic debulking procedure.As part of the staging and treatment, the surgeon performs a 38572 procedure to assess the extent of lymphatic spread., A patient with recurrent cervical cancer undergoes a laparoscopic lymph node dissection. The surgeon performs a bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, necessitating code 38572.

** For drainage of lymphocele to the peritoneal cavity, use code 49323.The endoscopic base code for this procedure is 49320 (Laparoscopy, abdomen, peritoneum, and omentum, diagnostic).

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