AHA Coding Clinic® for ICD-9 - 2012 Issue 2; Ask the Editor
Sentinel Node Biopsy with Modified Radical Mastectomy
Coding Clinic, Second Quarter 2002, page 7, states “if the sentinel node is positive, a complete axillary node dissection is usually carried out.” When a sentinel node biopsy is done followed by a modified radical mastectomy, should code 40.23, Excision of axillary lymph node, be assigned for the sentinel node biopsy, along with code 85.43, Unilateral extended simple mastectomy? A “simple mastectomy with excision of regional lymph nodes” is an inclusion at code 85.43. ...
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Article Overview
This article discusses a breast surgery coding question from Coding Clinic and explains the relevant procedure coding context for a sentinel node biopsy performed in the same operative episode as a modified radical mastectomy. It is intended for coders, CDI professionals, and other revenue cycle staff working with inpatient procedure reporting and related official guidance.
Why This Topic Matters
Articles like this help readers interpret official coding guidance for surgical episodes where multiple procedures may appear reportable. Understanding the discussion supports more consistent procedure coding and review of operative documentation in breast surgery cases.
What You Will Learn
- The coding context discussed for sentinel node biopsy in breast surgery
- How the article frames a modified radical mastectomy coding question
- How official guidance sources are referenced in relation to procedure reporting
- What type of inpatient procedure coding issue the article addresses
Who Should Read This
- Medical coders
- Coding auditors
- Clinical documentation integrity specialists
- Revenue cycle professionals
- Health information management staff
Codes Discussed
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