CPT® Code 39402

Mediastinoscopy is a surgical procedure utilized primarily for the evaluation of mediastinal lesions and to determine treatment options for patients suspected of having bronchogenic carcinoma, commonly known as lung cancer. This procedure involves making a small incision above the suprasternal notch, which is the area located at the top of the sternum, between the borders of the sternocleidomastoid muscle. The incision is carefully extended down to the pretracheal fascia, which is then divided to allow access to the mediastinum. A specialized instrument called a mediastinoscope is inserted through this incision and advanced behind the suprasternal notch, moving behind the aortic arch into the superior mediastinum. The mediastinoscope is maneuvered to the level of the carina, which is the point where the trachea divides into the left and right main bronchi. During this examination, the physician looks for any lesions, tumors, diseased tissue, or other abnormalities in the mediastinum and the main bronchi. If necessary, biopsies of any identified masses or lesions can be performed through the endoscope. Specifically, in the context of CPT® Code 39402, the procedure focuses on examining and biopsying mediastinal lymph nodes, which is crucial for staging lung cancer. After the necessary evaluations and biopsies are completed, the mediastinoscope is withdrawn, and the incisions are meticulously closed to ensure proper healing.