Ob-Gyn Coding Alert

Question: I have a physician who did a colpopexy (57283) and a vaginal removal of the left tube and ovary (58720). CPT says I cannot bill both a vaginal hysterectomy with tube/ovary removal with a colpopexy, so does this apply to left salpingo oophorectomy (LSO) as well? This is, are these codes bundled by NCCI?


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Answer: No, the National Correct Coding Initiative does not bundle vaginal removal of the tubes and ovaries (58720, Salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]) into a colpopexy (57283, Colpopexy, vaginal; intra-peritoneal approach [uterosacral, levator myorrhaphy]).

If you've read this somewhere, this information is wrong. CPT has a note after code 58263 (Vaginal hysterectomy, for uterus 250 grams or less; with removal of tube[s], and/or ovary[s], with repair of enterocele) that says you should not report 58263 in addition to 57283.

This note applies to the enterocele repair in that if your ob-gyn performs a vaginal hysterectomy with enterocele repair, you would not report an intra-peritoneal colpopexy in addition. If you are just reporting the removal of the ovaries, you don't need to worry about NCCI bundling the colpopexy and may report both codes together.