Summary & Overview
CPT 38900: Sentinel Lymph Node Mapping with Dye Injection
CPT code 38900 covers intraoperative sentinel lymph node mapping by injection of a nonradioactive dye and direct examination of regional lymph nodes to detect disease and identify primary draining nodes. This procedure is commonly performed concurrently with tumor resection or lymph node biopsy and is an important step in staging and surgical planning for cancers with lymphatic spread. Nationally, accurate coding of sentinel node mapping affects surgical documentation, case mix classification, and cross-payer comparability of oncologic operative care.
Key payers covered in this summary include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing context for CPT code 38900, including the procedure’s typical use during operative oncology, common sites of service, and considerations that influence coverage and claim adjudication. The publication also outlines benchmarks for utilization, recent policy updates affecting intraoperative mapping procedures, and implications for surgical workflow and coding accuracy.
Intended readers will learn how CPT code 38900 fits into perioperative cancer care, what documentation supports appropriate use, and where policy distinctions among major national payers and Medicare commonly arise. Data not available in the input will be noted where relevant.
Billing Code Overview
CPT code 38900 describes intraoperative injection of a nonradioactive dye into tissues surrounding lymph nodes with direct examination of those nodes to detect disease and identify primary draining (sentinel) lymph nodes. The procedure is typically performed at the time of a lymph node biopsy or tumor resection.
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Service type: Sentinel lymph node mapping with dye injection and lymph node examination
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Typical site of service: Operative/surgical suite or hospital operating room during tumor resection or lymph node biopsy
Clinical & Coding Specifications
Clinical Context
A 56-year-old woman with a recently diagnosed invasive breast carcinoma presents for surgical management. The surgical oncology team plans a lumpectomy with sentinel lymph node mapping and possible biopsy. Intraoperatively, the surgeon injects a nonradioactive blue dye into the peritumoral tissues to identify lymphatic drainage and visualize the sentinel lymph node(s). The operating room team monitors the patient under general anesthesia; the surgeon inspects regional lymphatic basins (axillary, supraclavicular, or internal mammary depending on tumor location) for dye uptake, removes identified sentinel nodes, and sends them to pathology for frozen section and permanent histology. Documentation includes the injection site(s), dye used, time of injection, number and location of nodes identified and removed, and any concurrent procedures (for example, 19301 lumpectomy or 38925 for lymph node excision if applicable). Typical site of service is an ambulatory surgery center or hospital operating room. The service is commonly performed at the time of tumor resection to stage regional nodal involvement and guide further oncologic treatment decisions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier information | Rarely used; placeholder when systems require a two-character modifier but none applies |