Ob-Gyn Coding Alert

Reader Questions:

Have a “Converted” Case? Do This

Question: My provider started out performing a LAVH. The procedure converted to a TAH due to: “attention was then turned to the right adnexa where it was thought that the right ureter was running in close proximity to the right adnexa and into an anterior fibroid. This was later found to be a large vessel; however, due to this finding it was decided to proceed with open laparotomy. The patient was returned to the dorsal supine position.” Do I still code the LAVH (251g uterus) (58553-52) and 58150?

Tennessee Subscriber

Answer: No, you report only the final procedure with 58150 (Total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]) and add a modifier 22 (Increased procedural services) to account for the laparoscopic work prior to converting.

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