CPT® Code 38720

The procedure described by CPT® Code 38720 refers to a complete cervical lymphadenectomy, commonly known as a radical neck dissection. This surgical intervention involves the removal of lymph nodes located in the cervical region, which are critical for the body's immune response and are often affected by malignancies. The lymph nodes in the neck are organized into six distinct levels, each with specific anatomical locations and clinical significance. Level I encompasses the submandibular and submental lymph nodes, while levels II through IV correspond to the compartments along the jugular lymph node chain, with level II situated above the hyoid bone, level III between the hyoid and the inferior border of the cricoid cartilage, and level IV extending from the cricoid cartilage to the clavicle. Level V includes nodes in the posterior triangle of the neck, and level VI pertains to nodes in the anterior compartment, although these are not typically included in a radical or modified radical neck dissection. The decision regarding which lymph node levels to excise is influenced by the location of the primary tumor and the anticipated spread of cancer. The surgical approach typically involves a curvilinear apron-type incision or a vertical incision, allowing for adequate exposure of the lymphatic structures. During the procedure, lymph node levels I-V on the affected side are meticulously dissected and excised, along with surrounding tissues such as the sternocleidomastoid muscle, internal jugular vein, and potentially other anatomical structures. This comprehensive approach aims to achieve complete removal of cancerous nodes to improve patient outcomes.