Ob-Gyn Coding Alert

Reader Question :

Modifier -51 Is the Key

Question: The ob-gyn performed an anteroposterior colporrhaphy, Burch urethropexy and bilateral salpingooophorectomy during one session. How should I report these multiple procedures?

Indiana Subscriber

Answer: You would report these procedures using the following codes: 57260 (Combined anteroposterior colporrhaphy), 51840 (Anterior vesicourethropexy, or urethropexy [e.g., Marshall-Marchetti-Krantz, Burch]; simple) and 58720 (Salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]). None of these codes is bundled under the national Correct Coding Initiative, so you should list the most extensive procedure first on the CMS 1500 claim form.

In addition, you should append modifier -51 (Multiple procedures) to the codes listed second and third. If the payer bundles one or two of the procedures, you should append modifier -59 (Distinct procedural service) to the bundled code.

Based on this information, you should list the codes on the claim form as follows:
1. 58720
2. 51840-51
3. 57260-51.

 

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