2024 HCPCS Code G8880

Documentation of reason(s) sentinel lymph node biopsy not performed (e.g., reasons could include but not limited to; non-invasive cancer, incidental discovery of breast cancer on prophylactic mastectomy, incidental discovery of breast cancer on reduction mammoplasty, pre-operative biopsy proven lymph node (ln) metastases, inflammatory carcinoma, stage 3 locally advanced cancer, recurrent invasive breast cancer, clinically node positive after neoadjuvant systemic therapy, patient refusal after informed consent, patient with significant age, comorbidities, or limited life expectancy and favorable tumor; adjuvant systemic therapy unlikely to change)

TAGS: prophylactic invasive neoadjuvant favorable performed sentinel reasons informed patient significant locally cancer advanced lymph inflammatory clinically reduction discovery could proven documentation recurrent limited refusal include stage incidental adjuvant expectancy positive systemic therapy unlikely biopsy

Short DescriptionSen lym p node biop not perf
HCPCS Coverage Code C - Carrier judgment
HCPCS Action Code N - No maintenance for this code
HCPCS Action Effective Date January 01, 2019
HCPCS Code Added Date January 01, 2012
HCPCS Pricing Indicator Code 00 - Service not separately priced by part B (e.G., services not covered, bundled, used by part a only, etc.)
HCPCS Multiple Pricing Indicator Code 9 - Not applicable as HCPCS not priced separately by part B (pricing indicator is 00) or value is not established (pricing indicator is '99')
HCPCS Coverage Issues Manual Reference Section Number
HCPCS Type Of Service Code 1 - Medical care
HCPCS Anesthesia Base Unit Quantity 0

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