Ob-Gyn Coding Alert

Question: What is the procedure code for laparoscopic LSO (left salpingo-oophorectomy) with ligation of an arterial pumper?

California Subscriber
 
 Answer: The correct code is 58661 (laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]). Billing separately for the ligation of the arterial bleeder depends on the cause of the bleeding. If it is a result of a mishap during surgery, hemostasis (repair of the artery) is included in the procedure. You cannot charge for any mishaps or errors. If there was bleeding prior to the surgery, you can attempt to bill 37617 (ligation, major artery [e.g., post-traumatic, rupture]; abdomen) or you can simply add modifier -22 (unusual procedural services) to 58661.