Ob-Gyn Coding Alert

You Be the Coder:

Include This in Your Laparoscopic RSOs

Published on Tue Sep 23, 2014

Question: Our ob-gyn did a laparoscopic right salpingo-oophorectomy (RSO) with excision of small bowel lesion and irrigated the peritoneal cavity. Can I code the excision and irrigation separately? If so, what code should I report for the excision?

Florida Subscriber

Answer: No, you cannot separately report the irrigation of the cavity as it, like peritoneal washing is included as part of the surgical technique. As for the excision of the lesion done laparoscopically, you have two options:

1) You can report 44238 (Unlisted laparoscopy procedure, intestine [except rectum]). Watch out: You shouldn’t report 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method) because this code is for peritoneal lesions, not bowel lesions.

2) You can add modifier 22 (Increased procedural services) to 58661 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]).

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