Go Back   AAPC Medical Coding & Billing Forums > Medical Coding > OB/GYN
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Reply
 
Thread Tools
  #1  
Old 03-19-2008, 03:30 PM
amjordan's Avatar
amjordan amjordan is offline
True Blue
 
Join Date: Apr 2007
Location: Kansas City, MO
Posts: 736
amjordan is on a distinguished road
Default TAH-BSO and bilateral pelvic lymph node dissection

I am having one of those moments where my brain is locked.

I just received a OP report with a denial from the insurance company. The codes billed out by the coder were 58150-62 and 38770-5062, they denied 38770-5062 as being inclusive to 58150. Nothing I can find in CCI, CPT or ACOG bundles this. Am I missing something?

The surgery was done for adenocarcinoma of the endometrium. The procedure included at TAH-BSO and they removed the obturator and iliac lymph nodes bilaterally. No omenectomy, or partial vaginectomy was performed. There was no evidence of extrauterine disease present.
__________________
Angela Jordan, CPC
AAPC of Kansas City, Region 5 - Southwest
Medical Revenue $olutions
Managing Consultant

angela@medicalrevenuesolutions.com
Reply With Quote
  #2  
Old 03-21-2008, 05:12 PM
becca12 becca12 is offline
Networker
 
Join Date: Apr 2007
Posts: 29
becca12 is on a distinguished road
Default

Hello, sometimes individual insurance companies have there own edits. So if I was you I would look on the insurance company website to see if they have there own edits. If they do then you might be able to appeal there decision. I know in the state I live in you can appeal an edit denial and sometimes you can get it paid.

Thanks

Rebecca
Reply With Quote
  #3  
Old 03-29-2008, 01:08 PM
garcia06 garcia06 is offline
Networker
 
Join Date: Apr 2007
Posts: 44
garcia06 is on a distinguished road
Default

if your report reads bilateral removal of lymphs? sometimes the provider report bilateral but in the context of the report they are not removed bilateraly, i notice that the sequence of the modifier on 38770 would be 62-50-51

or would it be best to code 58210 if there is more work involved in the procedure.(radical) it would be best to obtain your provider assistance.

Last edited by garcia06; 03-29-2008 at 01:11 PM.
Reply With Quote
Reply

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off




Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 01:32 PM.

AAPC - Top

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2014, Jelsoft Enterprises Ltd.
Copyright ©2014, AAPC