Ob-Gyn Coding Alert

From the Ob-Gyn Coding Alert
Extra Supplement on Endoscopic Procedures Question: How should I code laparoscopy with right ovarian cystectomy and fulguration of endometrial implants? Should I use 58662 and 58660-59 or just 58662? New Jersey Subscriber

Answer: You should use 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method) to report the fulguration of endometrial implants and the ovarian cystectomy because this code describes both of these procedures. In this case, if the physician has documented significant additional work when doing both, modifier -22 (Unusual procedural services) can be added to 58662. You should include documentation with the claim explaining the additional work, however. But note that if part of the ovary was removed with the cyst, you could report 58661-51 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or [...]