Summary & Overview
CPT 38542: Excision of Deep Jugular/Axillary Lymph Node
CPT code 38542 denotes the surgical excision of deep lymph nodes in the jugular/axillary region, a diagnostic and therapeutic procedure used to obtain tissue for pathologic evaluation when disease of the lymph node or adjacent structures is suspected. Nationally, this code is relevant to surgical oncology, general surgery, and otolaryngology practices because it supports diagnosis, staging, and management decisions for cancers and other pathologic processes involving regional lymphatics. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find benchmarks and clinical context for utilization of CPT code 38542, including typical sites of service and the clinical rationale for deep axillary/jugular node excision. The publication summarizes coverage considerations and payer alignment at a national level, highlights common coding relationships, and outlines what to expect in claims processing and service line classification. Data not provided in the input are identified explicitly, and the report focuses on nationally applicable information for clinicians, billing staff, and policy analysts seeking clarity on the role and application of this surgical lymph node excision code.
Billing Code Overview
CPT code 38542 describes the surgical excision of deep lymph nodes in the jugular (axillary/underarm) region. The procedure involves removal of lymph nodes that lie beneath layers of muscle or bone in the axilla and is commonly performed to obtain tissue for diagnosis of disease affecting the lymph node or surrounding tissues.
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Service type: Surgical lymph node excision (deep axillary/jugular lymphadenectomy)
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Typical site of service: Operating room or ambulatory surgical center; inpatient surgical setting may be used depending on clinical context and patient condition.
Clinical & Coding Specifications
Clinical Context
A 52-year-old female presents with a palpable, enlarging mass in the left axilla found on clinical exam and imaging (ultrasound) suspicious for nodal metastasis. The surgeon schedules an excisional lymph node biopsy of an axillary node located deep to the fascia and adjacent to the neurovascular bundle to obtain tissue for histopathology and immunohistochemical studies to confirm or exclude malignancy. The clinical workflow includes preoperative evaluation (history, focused exam, consent), imaging review, preoperative labs, operative removal of the deep axillary lymph node under general anesthesia with careful dissection to preserve surrounding structures, specimen labeling and submission to pathology (including frozen section if requested), postoperative monitoring in the recovery area, and documentation of the procedure, findings, complications, and pathology follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier appended (standard) | Use when no special modifier applies and the service is reported as usual. |
11 | Normal, or standard service | Use to indicate the usual, uncomplicated performance of the procedure. |