CPT® Code 38520

The procedure described by CPT® Code 38520 involves an open biopsy or excision of deep cervical lymph nodes, specifically targeting those located within the deep cervical region of the neck. Deep cervical lymph nodes are critical components of the lymphatic system and include various chains such as the spinal accessory chain, transverse cervical chain, and the Delphian node. During this procedure, a surgical incision is made in the skin over the affected lymph nodes, allowing access to the underlying structures. The platysma muscle, which is a thin layer of muscle in the neck, is incised to facilitate deeper dissection. Surgeons carefully navigate through the soft tissues, ensuring the protection of surrounding nerves and blood vessels to minimize complications. Once the lymph nodes are adequately exposed, one or more nodes are dissected free from their surrounding tissues for removal or to obtain tissue samples for further analysis. Additionally, the procedure may involve the biopsy or excision of lymph nodes located within the scalene fat pad, which is situated beneath the inferior aspect of the scalene muscle and contains a small number of lymph nodes. To access this area, a supraclavicular skin incision is made, and the dissection continues through the platysma muscle. The sternocleidomastoid muscle is then divided near its attachment to the clavicle, allowing for the exposure of the scalene fat pad. The scalene fat pad is meticulously dissected from surrounding tissues and removed in its entirety. All excised lymph nodes, tissue samples, and the scalene fat pad are subsequently sent to the laboratory for histological evaluation, which is essential for diagnosing any underlying conditions. It is important to note that CPT® Code 38510 should be used when a deep cervical lymph node biopsy or excision is performed without the excision of the scalene fat pad, while CPT® Code 38520 is specifically designated for cases where scalene fat pad excision is included in the procedure.