Ob-Gyn Coding Alert

The AUGS submitted a letter objecting to this edit.

A subscriber recently contacted us about the National Correct Coding Initiative (NCCI) edit bundling 58552 (Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube[s] and/or ovary[s]) and 57260 (Combined anteroposterior colporrhaphy).

Right now: Code 57260 is a column 2 code for 58552 with a modifier indicator of “0.” This means you cannot bill these codes together under any circumstances. Code 57260 is bundled into code 58552. CCI edit rule states, “Misuse of column two code with column one code.”

Prior to when this edit went into effect (October 1, 2014), you could bill both procedures with a modifier 51 (Multiple procedures) applied to 57260, thus reducing the additional service by 50 percent.

However, the American Urogynecology Society (AUGS) is fighting CMS and has submitted a letter objecting to this edit according to a November 2015 letter (See URL: www.augs.org/p/cm/ld/fid=82). Stay tuned for updates as to whether this edit will be overturned.