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2025 CPT code 39220

Resection of mediastinal tumor.

Code 39220 is reported for open resection of mediastinal tumors, excluding heart and great vessel tumors and substernal thyroidectomy. Confirm pathology results for accurate diagnosis coding. Use appropriate unlisted codes for procedures not specifically described, such as mediastinoscopic excision.

Modifiers may be applicable to indicate specific circumstances of the procedure, such as increased procedural services (22), multiple procedures (51), or assistant surgeon (80).

Medical necessity is established by the presence of a mediastinal tumor causing symptoms or posing a risk to the patient's health. Imaging studies and/or biopsy results confirming the presence and nature of the tumor are essential for justifying the procedure.

The surgeon prepares the patient, administers anesthesia, and positions them appropriately for the procedure. The surgeon makes the necessary incisions, performs the resection of the mediastinal tumor, controls bleeding, and closes the surgical site.

IMPORTANT:For substernal thyroidectomy, use 60270. For thymectomy, use 60520. For thoracoscopic (VATS) resection of mediastinal cyst, tumor, or mass, use 32662. For mediastinal tumor excision via mediastinoscopy, use 39499 (Unlisted procedure, mediastinum).

In simple words: The surgeon opens the chest through the breastbone or between the ribs to reach the area between the lungs. They then remove a tumor found in this area.

This code describes an open surgical procedure to remove a tumor located in the mediastinum, the space between the lungs. This includes making an incision in the thorax (thoracotomy) or sternum (sternotomy) to access and resect the tumor. This code excludes tumors of the heart, great vessels, and substernal thyroidectomy.

Example 1: A patient presents with a symptomatic mediastinal mass confirmed by imaging studies. The surgeon performs a thoracotomy to remove the tumor., A patient with myasthenia gravis undergoes a sternotomy for resection of a thymoma, a tumor originating from the thymus gland located in the mediastinum., A biopsy reveals a malignant mediastinal tumor. The surgeon performs a median sternotomy for complete resection of the tumor.

Documentation should include operative report detailing the surgical approach (thoracotomy or sternotomy), size and location of the tumor, surgical technique used, and any complications encountered. Pathology report confirming the diagnosis of the mediastinal tumor is crucial for accurate coding.

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