Specimen resections sometimes bundle in other nearby structures so that they are not separately billable from the resection charge. Simple biopsies or excisions would not be bundled with other specimens – this list below is for resections/partial resections of entire organs and the lymph node groups that would be bundled in that charge. Remember that sentinel nodes are always separately billed, provided they are individually identified and diagnosed.
|Resection Specimen||Lymph Nodes|
|Bone Marrow||Billed separately|
|Breast Mastectomy||Resection coding depends on the presence of lymph nodes. Code 88307 (Breast, mastectomy, partial/simple) when regional lymph nodes aren't present, but 88309 (Breast, mastectomy, with regional lymph nodes) when they are.|
|Colon Resection||Regional lymph nodes of the mesentery are bundled (including but not limited to paracolic nodes). Sentinel lymph node is always separately billed provided it is separately diagnosed. Remote regional nodes (i.e. pelvic or retroperitoneal) are separately billed.|
|Larynx||Cervical (Level III) and paratracheal (Level IV) are bundled with a laryngectomy specimen. Any other submitted lymph nodes can be billed. Sentinel node is always separately billed provided it is separately diagnosed.|
|Lung||Hilar/intrapulmonary lymph node groups are bundled with the resection specimen. Sentinel node is always separately billed provided it is separately diagnosed.|
|Pancreas||Pancreatic/pyloric lymph nodes are bundled with the pancreas specimen; however, if a node biopsy from one of these groups is separately submitted by the surgeon, it can be separately charged.|