tci General Surgery Coding Alert - 2007 Issue 12

Reader Questions: Turn to Modifiers for Bilateral Breast Injection

Question: When the physician performs four injections in the left breast for one sentinel node and four injections in the right breast for one sentinel node, how should I code? Maryland Subscriber Answer: Physicians often perform more than one injection to identify the sentinel node from a single breast cancer or biopsy site. If the patient has tumors in both breasts, you should report 38792 (Injection procedure; for identification of sentinel node) once for each breast. Code 38792 is eligible for bilateral payment, so you can report the code once with modifier 50 (Bilateral procedure), or you can report...

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