A 39-year-old patient with invasive ductal cancer of the right breast, status post neoadjuvant chemotherapy, underwent modified radical mastectomy of the right breast. During the axillary dissection, the provider removed level 1, level 2 and parts of level 3 lymph nodes. We assigned a code for the modified radical mastectomy of the right breast, but are seeking clarification of whether each axillary lymph node level is considered a separate body part (4th character), and therefore, multiple codes are assigned?
Each lymph node level is considered a chain. When the intent is to remove an entire chain of lymph nodes, rather than isolated nodes, the root operation “Resection” is coded. The axillary lymph nodes are all considered a single body part and therefore multiple procedure codes would not be assigned for the cutting out of various axillary lymph node levels. Assign the following ICD-10-PCS code for the right axillary lymph node resection:
07T50ZZ Resection of right axillary lymphatic, open approach