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The procedure described by CPT® Code 38555 involves the excision of a cystic hygroma located in the axillary or cervical region, accompanied by deep neurovascular dissection. A cystic hygroma, also known as a cystic lymphangioma, is characterized by the presence of one or more cysts filled with lymphatic fluid, which results from a blockage in the lymphatic system. These cysts can be congenital, meaning they are present at birth, or they may develop later in life. The excision process begins with an incision through the skin and subcutaneous tissue that covers the cystic hygroma. In cases where the cyst is situated in the axilla, the surgeon must carefully open deeper tissues to expose the cystic mass, ensuring that surrounding nerves and blood vessels are preserved during dissection. If the cystic hygroma is located in the neck, the procedure involves incising the platysma muscle and creating subplatysmal flaps. The depth of the cystic mass may necessitate further dissection of deeper tissues, which requires meticulous care to avoid damaging critical structures such as the carotid sheath, which houses the carotid artery, internal jugular vein, and vagus nerve. The dissection continues until the cystic sac is completely separated from the surrounding tissues, allowing for its removal. In instances where multiple cystic sacs are present, each sac is dissected and excised individually. This procedure is distinct from CPT® Code 38550, which is used for the excision of a cystic hygroma that does not require deep neurovascular dissection.
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The excision of a cystic hygroma, as described by CPT® Code 38555, is indicated for the following conditions:
The procedure for excising a cystic hygroma with deep neurovascular dissection involves several critical steps:
After the excision of a cystic hygroma with deep neurovascular dissection, post-procedure care is essential for optimal recovery. Patients may experience swelling and discomfort at the surgical site, which can be managed with appropriate pain relief measures. Monitoring for any signs of infection or complications is crucial during the recovery period. Follow-up appointments are typically scheduled to assess healing and ensure that the surgical site is recovering properly. Patients are advised to avoid strenuous activities for a specified period to facilitate healing and minimize the risk of complications. The specific duration of recovery and any additional care instructions will be provided by the healthcare provider based on the individual patient's condition and the extent of the procedure performed.
| Short Descr | REMOVAL NECK/ARMPIT LESION | Medium Descr | EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ | Long Descr | Excision of cystic hygroma, axillary or cervical; with deep neurovascular dissection | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 67 - Other therapeutic procedures, hemic and lymphatic system |
| 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |