They were replying to the direct question about when to use the code
25 and when to use 02 for an excisional lymph node biopsy of
lymphomas. The reason the page number was probably not included is
because they have already relayed that information to us in the past
and that the decision to choose a code higher than 02 is going to be
in a rare instance for nodal lymphomas. Although many may disagree
with this and say that the standards are what we all need to follow,
you can easily see proof in the NCDB data base when you select
cancer directed surgery codes for NHL cases. We were told that the
diagnostic and staging procedure codes were developed to be used in
case such as this. If I can go back and find any more details on
page number in FORDS to find the answer, etc, I'll be more than
happy to send it in. Refer to question #12835 in the I&R in the
meantime.

Thanks,
Charla

-- In cancerregistrargroup@yahoogroups.com, robokatie1
<no_reply@y...> wrote:
>
> >
> > Thought you'd like to see the latest.
> >
> > Question 12835: Our physicians say the excision of the lymph
node
> > is for diagnostic and staging not a surgically directed surgery
so
> > it should be coded 02 not 25. They said most lymphoma unless
> > extranodal are not surgically resected
> >
> > In Reply:
> > We agree with your physicians that most lymphoma lymph node
> > excisions are for diagnosis and staging and should be coded as a
> > Surgical Diagnostic and Staging Procedure rather than a Surgical
> > Procedure of the Primary Site. The latter code is provided for
> > recording the less common situation when the procedure meets the
> > definition of an excisional biopsy.
> >
> > Sincerely yours,
> >
> > I & R System
> > American College of Surgeons
> > Fax: 312-202-5009
> > E-mail: inquiry@f...
>
>
> I noticed that I&R didn't specify who's definition of an
excisional
> biopsy we are supposed to use.
>
> Maybe they should have said "when the procedure meets the FORDS
> definition of an excisional bx" and then refer us to the
appropriate
> page number.
>
> Regards
> Robo