Ob-Gyn Coding Alert

Question: Can I bill for all of the following procedures together: laparoscopy with salpingostomy (58673), laparoscopy with fulguration (58662), laparoscopy with lysis of adhesions (58660) and chromotubation (58350*)?
      
Idaho Subscriber

 
Answer: There is nothing wrong with billing all the procedures you have listed, as long as each is medically justified by at least one diagnosis code.
 
Chromotubation will not be paid unless it is done as a diagnostic procedure prior to the surgery (it will not be paid if it was done to confirm if the tubes were open after the removal of the endometrial implants or adhesions).
 
Many payers will also not reimburse separately for lysis of adhesions. If they were extensive and are well documented in the operative report, you may want to add modifier -22 (Unusual procedural services) to the primary surgical procedure (58673).
 
Remember to add modifier -51 (Multiple procedures) to all of the other procedures for which you bill.