Ob-Gyn Coding Alert
Report What Your MD Performed, Not What He Planned To Perform
Question: My ob-gyn has a patient scheduled for a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Another physician performed a bilateral periaortic and partial pelvic (common iliac nodes) lymphadenectomy, because the patient had endometrial adenocarcinoma. My ob-gyn removed both tubes and ovaries but did not perform the planed hysterectomy due to some concerns with the local extension of the tumor the patient had. Here's what the note stated: Preoperative Dx- endometrial adenocarcinoma well differentiated Need For Surgical Staging Post Op Dx- Endometrial Adenocarcinoma well differentiated Probable locally advanced endometrial adenocarcinoma with invasion of right pelvic sidewall inability to perform hysterectomy What should I report for my physician's portion? Connecticut Subscriber Answer: Because this was an initial surgery for endometrial -- and not ovarian -- cancer you can only bill each part of the surgery separately. This means that your ob-gyn bills 58720 (Salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]). This code qualifies the service that he performed. Remember, you can't bill for what he may have planned but did not perform. The other physician will bill for the staging (which would most likely be 38562, Limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic).
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