Summary & Overview
CPT 38562: Pelvic/Aortic Lymphadenectomy for Cancer Staging
CPT code 38562 represents surgical excision of pelvic and/or aortic lymph nodes (lymphadenectomy) performed to determine cancer stage in the pelvis. This code is important nationally because lymphadenectomy influences staging, prognosis, and subsequent cancer-directed treatment decisions across multiple malignancies that involve pelvic lymphatic drainage.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, plus coverage and billing considerations commonly encountered across major commercial and public payers. The report summarizes typical sites of service, coding scope, and common payer patterns where available.
The publication provides operational benchmarks for service utilization, summarizes relevant policy trends and coverage considerations, and situates CPT code 38562 within perioperative cancer care workflows. Content is intended for billing managers, surgical departments, and policy analysts seeking a national overview of how pelvic/aortic lymphadenectomy is categorized and processed in payer systems. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 38562 describes an excisional lymphadenectomy of pelvic and/or aortic lymph nodes performed to assess cancer staging in the pelvis. The procedure involves surgical removal of lymph nodes from the pelvic region or adjacent to the aorta to obtain tissue for pathologic evaluation and staging.
Service Type: Surgical - Lymphadenectomy for cancer staging
Typical Site of Service: Hospital operating room or ambulatory surgical center, with inpatient or outpatient surgical admission depending on clinical factors and surgical extent.
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old woman with newly diagnosed endometrial adenocarcinoma scheduled for staging surgery. Preoperative imaging shows no distant metastasis but possible pelvic lymph node involvement. In the operating room under general anesthesia, the gynecologic oncology surgeon performs a total hysterectomy with bilateral salpingo-oophorectomy and excises pelvic and/or para-aortic lymph nodes (38562) to obtain tissue for pathological staging. Intraoperative steps include identification of vascular landmarks, careful dissection along the iliac vessels and aortic bifurcation, hemostasis, and specimen orientation for the pathologist. The procedure may be open or performed via minimally invasive approach; specimens are sent fresh for histopathology and may be submitted for frozen section if intraoperative decisions depend on nodal status. Typical site of service is an acute care hospital operating room or ambulatory surgery center when clinically appropriate. Common concurrent perioperative services include anesthesia, surgical pathology, and postoperative inpatient recovery with nursing and postoperative pain management.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Unrelated evaluation and management service by the same physician on the same day of the procedure | Use when a significant, separate E/M service is provided on the same day as unrelated to the surgical procedure. |