urology

How would you code radical retropubic prostatectomy with obturator lymph node dissction? 55840 or 55845

What if the op-report don't mention hypogastric in 55845. Would you still use this
code?

Thank you,
Joanna

radical prostatectomy

Code 55840, Prostatectomy, retropubic radical, with or without nerve sparing; should be reported for the removal of the prostate gland through an abdominal incision.
Codes 55840, 55842, and 55845 are intended to describe an open procedure for removal of prostate with or without surrounding lymphatic tissue.

Code 55842 describes "biopsy(s).

Code 55845 is an extended procedure because it includes bilateral pelvic lymphadenectomy. Review of the operative note should point to accurate code. A pelvic lymphadenectomy includes removal of external iliac, hypogastric and obturator nodes.
It is difficult to give an accurate code without viewing the operative note. Discuss with physician the work performed and encourage complete documentation to support code.