2025 CPT code 38790
(Active) Effective Date: N/A Surgery - Surgical Procedures on the Hemic and Lymphatic Systems Feed
Injection procedure for lymphangiography.
Modifier 50 is used for bilateral procedures (performed on both sides of the body).Modifier 51 is used for multiple procedures performed at the same time, and other modifiers like 22, 47, 52, 58, 59, 73, 74, 76, 77, 78, 79, 99, and others might be applicable depending on the circumstances of the procedure.
Medical necessity must be established for this procedure. This may involve documentation of signs, symptoms, or other objective findings that suggest a lymphatic system disorder requiring diagnostic imaging. The documentation should clearly explain why the lymphangiogram is necessary for diagnosis or treatment planning.
The physician is responsible for identifying the target lymphatic ducts, making the incision, injecting the contrast dye, performing and interpreting the X-rays, managing any bleeding, and closing the incision. The physician is also responsible for selecting the appropriate contrast material based on the patient’s health status.
In simple words: This procedure involves injecting a special dye into the lymph vessels and then taking X-rays to create pictures of the lymphatic system. This helps doctors check for any problems like blockages or leaks in the lymph vessels.
This code represents a two-stage lymphangiography, involving the injection of a contrast dye into the lymphatic ducts followed by X-ray examination to visualize the lymphatic system.The procedure includes identifying the lymphatic ducts, making a small incision for access, injecting the contrast dye, taking X-rays, examining the ducts for abnormalities (leakage, blockage, etc.), applying pressure to stop any bleeding, and closing the incision with sutures.
Example 1: A patient presents with swelling in the leg, and the physician suspects lymphedema. A lymphangiogram (38790) is performed to assess the lymphatic drainage and identify any blockage or abnormalities in the lymphatic system., A patient with a history of lymphoma undergoes a lymphangiogram (38790) to evaluate the extent of lymph node involvement and aid in treatment planning., A patient with suspected lymphatic leakage following surgery undergoes a lymphangiogram (38790) to pinpoint the location of the leak.
Documentation should include details about the injection site, the type and amount of contrast material used, the X-ray findings, any complications encountered during the procedure, and the overall assessment of the lymphatic system.
- Specialties:The medical specialties typically performing and interpreting a lymphangiogram include interventional radiology, vascular surgery, and sometimes oncology or general surgery, depending on the clinical circumstances.
- Place of Service:This procedure can be performed in various places of service, including: "Inpatient Hospital", "Outpatient Hospital", "Ambulatory Surgical Center", "Independent Clinic", "Physician's Office". The specific place of service will depend on the patient’s condition and the facility’s capabilities.