Clarification Regarding Lymph Nodes versus Lymph Node Chains
By: Amphion’s Training and Education Team
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Coding Clinic for ICD-10-CM and ICD-10-PCS, 3rd Quarter, 2014, Page 9
Radical Resection of Level 1 Lymph Nodes
ICD-10-PCS Reference Manual 2015, Page 42
“When an entire lymph node chain is cut out, the appropriate root operation is Resection. When a lymph node(s) is cut out, the root operation is Excision.”
Coding Clinic also provides the following explanations.
Coding Clinic instructs to code the removal of level 1 lymph nodes to the root operation Resection. Each level is considered an entire lymph node chain.
The following lymph node resections are coded to the root operation
Resection:
Radical resection = removal of all the lymph nodes
Modified radical resection = removal of all lymph nodes
Each level of lymph nodes = an entire lymph node chain
The following lymph node resection is coded to the root operation
Excision:
Sampling of lymph nodes, ie. Sentinel nodes.
Radical resection of an organ is not synonymous with radical resections of lymph nodes. When an entire organ is removed, check the pathology report to determine if lymph nodes were removed and the extent.
If you have any questions about this coding tip, please feel free to email us.
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