Ob-Gyn Coding Alert

Question: My ob-gyn did a diagnostic laparoscopy, an exploratory laparotomy, and a cornual resection for an ectopic pregnancy. I have the laparoscopic procedures figured out, but what is the code for the cornual resection?

Maine Subscriber

Answer: Because this was a procedure that was converted from laparoscopic to open, you will report the final open procedure. In this case, the CPT^® code that represents the resection of a cornual ectopic pregnancy through an open incision is 59136 (Surgical treatment of ectopic pregnancy; interstitial, uterine pregnancy with partial resection of uterus). A cornual ectopic pregnancy is basically synonymous with a interstitial pregnancy because this type of pregnancy develops in the uterine portion of the fallopian tube.

You may not bill for the exploratory laparotomy since that is included in all open procedures, but you should add a modifier 22 (Increased procedural services) to code 59136 to cover the laparoscopic portion of the surgery.

ICD-10: After October 1, 2016, you will be able to also  report Z53.31 (Laparoscopic surgical procedure converted to open procedure).