Ask a Rev Cycle Expert: Sentinel Node Injection?
Would you please provide some clarification regarding Current Procedural Terminology (CPT®) code 38792 Injection procedure; radioactive tracer for identification of sentinel node? Guidance in the Current Procedural Terminology (CPT®) indicates there is a radiology supervision and interpretation (RS&I) relationship with CPT® code 78195 Lymphatics and lymph nodes imaging, yet there is a National Correct Coding Initiative (NCCI) Procedure-To-Procedure (PTP) edit for these two codes. Why is there a discrepancy with the two coding sources?
The injection of the radioactive tracer is a component of CPT® code 78195 Lymphatics and lymph nodes imaging, so CPT® code 38792 Injection procedure; radioactive tracer for identification of sentinel node should not be reported on the same date of service. In the instance where the patient is injected with the radiotracer and is sent home for the day, then returns another day for the imaging, then both codes may be reported using the dates the services were rendered.
Because of the misuse of the two codes together on the same date of service, the Centers of Medicare & Medicaid Services (CMS) has published a National Correct Coding Initiative (NCCI) Procedure-To-Procedure (PTP) edit between the code pair.
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