2025 CPT code 38573
Effective Date: N/A Surgery - Surgical Procedures on the Hemic and Lymphatic Systems Surgery Feed
Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling, peritoneal washings, peritoneal biopsy(ies), omentectomy, and diaphragmatic washings, including diaphragmatic and other serosal biopsy(ies), when performed.
Modifiers may be applicable depending on specific circumstances. Refer to CPT modifier guidelines for appropriate usage.
Medical necessity should be supported by evidence of malignancy or suspected metastasis requiring surgical intervention for staging, treatment, or prevention of further spread. Clinical findings, imaging studies, and other relevant diagnostic information must substantiate the need for the extensive laparoscopic procedure.
The physician is responsible for the complete laparoscopic procedure, including the incisions, insufflation, lymph node excisions, peritoneal and diaphragmatic washings, omentectomy, biopsies, and closure of incisions.
In simple words: The surgeon uses a small camera and tiny instruments inserted through small incisions in the abdomen to remove lymph nodes in the pelvis and near the aorta, wash the abdomen and diaphragm, and remove a fatty tissue called the omentum.They may also take tissue samples for examination. This procedure is done to treat and prevent the spread of cancer.
The provider performs a laparoscopic procedure to excise all lymph nodes on both sides of the pelvis, take samples of lymph nodes in the aortic area along with peritoneal and diaphragmatic washings, and excise the omentum. Biopsies of the serosa lining the peritoneal cavity may also be taken.This procedure aims to remove diseased lymph nodes and prevent cancer from spreading.
Example 1: A patient with endometrial cancer undergoes laparoscopic surgery for removal of pelvic lymph nodes, peri-aortic lymph node sampling, peritoneal and diaphragmatic washings, omentectomy, and biopsies to assess the extent of cancer spread., A patient with ovarian cancer undergoes a laparoscopic procedure that includes bilateral total pelvic lymphadenectomy, peri-aortic lymph node sampling, peritoneal washings, and biopsies to determine the stage of the cancer., A patient with suspected abdominal metastasis undergoes a diagnostic laparoscopy, including peritoneal and diaphragmatic washings, biopsies, and omentectomy.During the procedure, a decision is made to perform a total pelvic lymphadenectomy and peri-aortic lymph node sampling based on intraoperative findings.
Documentation should include operative report detailing the laparoscopic procedure, including the size and location of incisions, type of insufflation used, specific lymph nodes removed, areas washed, biopsies taken, omentectomy performed (partial or total), and findings related to cancer spread. Pathology reports for the biopsies are crucial. Preoperative and postoperative diagnoses, and any complications encountered should also be documented.
- Revenue Code: P5E - AMBULATORY PROCEDURES - OTHER
- Specialties:Gynecologic Oncology, Surgical Oncology
- Place of Service:Ambulatory Surgical Center, Hospital, Outpatient Hospital