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2025 CPT code 38780

Extensive retroperitoneal transabdominal lymphadenectomy, including pelvic, aortic, and renal nodes (separate procedure).

Refer to current CPT coding guidelines and any applicable payer-specific guidelines for proper coding and billing of this procedure.

Modifiers may be applicable to this code depending on the specific circumstances of the procedure. Consult iFrameAI for a complete list of applicable modifiers and scenarios necessitating their usage.

Medical necessity must be established by demonstrating the presence of malignancy or other conditions requiring extensive lymphadenectomy. This may involve imaging studies, biopsy results, and other clinical findings indicating the spread of cancer or other diseases to the retroperitoneal lymph nodes.

The physician is responsible for the complete surgical procedure, including prepping and anesthetizing the patient, making the incision, inspecting the abdominal cavity, removing lymph nodes and affected tissues, ensuring hemostasis, and closing the incision.

IMPORTANT:(For excision and repair of lymphedematous skin and subcutaneous tissue, see 15004-15005, 15570-15650)

In simple words: This procedure involves the extensive removal of lymph nodes in the abdomen, including those around the pelvis, aorta, and kidneys.It is often done to treat cancer that has spread to these lymph nodes.The surgeon makes a large incision in the abdomen to access and remove the nodes.

The provider performs extensive surgical excision of the lymph nodes from the retroperitoneal area and throughout the abdomen. This includes the pelvic, aortic, and renal lymph nodes.The procedure involves a long incision from the distal tip of the sternum to the umbilicus, inspection of the abdominal cavity, removal of adhesions, and evacuation of fluid.The provider removes the specified lymph nodes and any other affected tissues in the area.Hemostasis is ensured, and the incision is closed in layers.

Example 1: A patient with testicular cancer that has spread to the retroperitoneal lymph nodes undergoes this procedure as part of their cancer treatment., A patient with ovarian cancer with metastasis to the pelvic and para-aortic lymph nodes undergoes this extensive lymphadenectomy., A patient with lymphoma affecting the abdominal lymph nodes undergoes this procedure for diagnostic and therapeutic purposes.

Documentation should include operative report detailing the extent of lymphadenectomy, specific lymph node groups removed (pelvic, aortic, renal, etc.), any other tissues or organs involved, and any complications encountered. Preoperative diagnostic imaging and pathology reports confirming the need for the procedure are also necessary.

** It's crucial to ensure thorough documentation to support the medical necessity and accurate coding of this extensive procedure.

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