Ob-Gyn Coding Alert

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

Florida Subscriber

Answer: No, you cannot separately report the aspiration of the peritoneal fluid. As for the excision of the lesion done laparoscopically, you have two options:

1) You can report 44238 (Unlisted laparoscopic 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 service) to 58661 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]).