JSAXTON
New
Wondering if anyone has success getting paid for both of these procedures when billed together? From my research there is no CCI edit....but of course the carriers says there is. 
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Wiki 58661 and 58662
- Thread starter JSAXTON
- Start date
let us place it this way:
58661: Lap, surgical; with removal of ADNEXAL STRUCTURES( partial or total oopherectomy AND or salpingectomy - meaning all structures belonging to adnexa removal ,or partial, or some total and/or some of them partial. Right?
58662: Lap,surgical: with fulguration or excision of lesions of ovary(which is not removal of ovary but any other things- can be cystectomy, wedge resection, ovariotomy or simply fulguration etc), pelvic viscera or peritoneal surface by any method.
One session, same lap procedure and same surgeon same anatomical structure/ or other anatomical structures also included!! Also depends on the involvement of the structures and procedures!
Pelvic viscera: those organs other than adnexal organs(ie ovaries and tubes, peri and para tubal ducts, structures and ligaments and surrounding structures),
Say for example, Appendix, bladder ureter, uterus or pelvic digestive tracts/organs lymph nodes and system not in adenexa, are not included in adnexal removal.
Now let us figure it out: some of the descriptional elements in 58662 like fulguration excision of lesions ovary can be included with the 58661 procedures with modifiers rather than separately reporting them as 58662 what ever suitable-as -22 or 59. Because the intended surgery was 58661 and intraoperatively they had to increase/extent the procedure on to fulgration or excision of adnexal contents even other pelvic or pelvic peritoneal lesion fulgration /excision as for my openion
If the surgeon goes on with fulguration and excision of LESIONS of OTHER ORGANS cited in 58662, can also be appended all the more with-59 on to 58661
Whether can be taken as separate procedure because those anatomical structures
are not included in 58661 procedure is still may not be accepted by the payers if the physician's document do explain.; may accept for appending 59
The bottom line of my discusssion is this:
58661 can accept and include some or partial procedures in the 58662 but not the 58662 can fold/contain all that in 58661
you could try to append 22 or 59 on to 58661 with a document/report from Physician explaining the whole lot of procedures done.
This only for discussion ! Give a trial !!
58661: Lap, surgical; with removal of ADNEXAL STRUCTURES( partial or total oopherectomy AND or salpingectomy - meaning all structures belonging to adnexa removal ,or partial, or some total and/or some of them partial. Right?
58662: Lap,surgical: with fulguration or excision of lesions of ovary(which is not removal of ovary but any other things- can be cystectomy, wedge resection, ovariotomy or simply fulguration etc), pelvic viscera or peritoneal surface by any method.
One session, same lap procedure and same surgeon same anatomical structure/ or other anatomical structures also included!! Also depends on the involvement of the structures and procedures!
Pelvic viscera: those organs other than adnexal organs(ie ovaries and tubes, peri and para tubal ducts, structures and ligaments and surrounding structures),
Say for example, Appendix, bladder ureter, uterus or pelvic digestive tracts/organs lymph nodes and system not in adenexa, are not included in adnexal removal.
Now let us figure it out: some of the descriptional elements in 58662 like fulguration excision of lesions ovary can be included with the 58661 procedures with modifiers rather than separately reporting them as 58662 what ever suitable-as -22 or 59. Because the intended surgery was 58661 and intraoperatively they had to increase/extent the procedure on to fulgration or excision of adnexal contents even other pelvic or pelvic peritoneal lesion fulgration /excision as for my openion
If the surgeon goes on with fulguration and excision of LESIONS of OTHER ORGANS cited in 58662, can also be appended all the more with-59 on to 58661
Whether can be taken as separate procedure because those anatomical structures
are not included in 58661 procedure is still may not be accepted by the payers if the physician's document do explain.; may accept for appending 59
The bottom line of my discusssion is this:
58661 can accept and include some or partial procedures in the 58662 but not the 58662 can fold/contain all that in 58661
you could try to append 22 or 59 on to 58661 with a document/report from Physician explaining the whole lot of procedures done.
This only for discussion ! Give a trial !!
Last edited:
Korbc
Expert
hey there preserene,
just wondering your opinion on this. my doctor removed endometriosis and wants to code the 58662 with 58661, this is a description of what she did. Not sure if I can code it separately with the 58662 or if i should do a 22 on 58661
"Small areas of endometriosis in the cul-de-sac and ovarian fossa were fulgurated with monopolar scissors. A small peritoneal implant of likely endometriosis was removed using monopolar scissors and passed off for permanent pathology. Adhesions from the sigmoid to the left pelvic sidewall were taken down with LigaSure and monopolar scissors."
just wondering your opinion on this. my doctor removed endometriosis and wants to code the 58662 with 58661, this is a description of what she did. Not sure if I can code it separately with the 58662 or if i should do a 22 on 58661
"Small areas of endometriosis in the cul-de-sac and ovarian fossa were fulgurated with monopolar scissors. A small peritoneal implant of likely endometriosis was removed using monopolar scissors and passed off for permanent pathology. Adhesions from the sigmoid to the left pelvic sidewall were taken down with LigaSure and monopolar scissors."
Since the original post was from 2010 and preserene hasn't been on the forums in 10 years, I figure I'll weigh in with my opinion here.
NCCI edits can and do change (quarterly in fact). 58662 and 58661 are not currently NCCI edits.
As the endometriosis was removed from the cul-de-sac which would be separate from removing the tubes/ovaries, I would code for both 58662 and 58661. If the carrier were to bundle, I would ask for a copy of their policy. Depending on whether they could provide one, I would either appeal, or reluctantly bill with -22. If there is an official written policy, it is hard to overturn that decision with an appeal.
Korbc
Expert
Thanks so very much! csperoni! where do you prefer to go to check the quarterly edits?
nielynco
True Blue
https://www.cms.gov/medicare-medica...e/medicare-ncci-procedure-procedure-ptp-edits
This will give you quarterly edits and you can also download the whole file of edits, not just the changes from this page.
Yes, the CMS download will certainly provide the edits, but not necessarily in the most user friendly way. In the real world, most coders I know will use some type of online encoder where you can simply plug in your CPTs to see if they hit edits. Some EHRs have encoder software built into it.
For me personally, our EHR does not have software built in, but there are SOME edits that have been manually added. I use Codify (simply because it is what my employer pays for) to check NCCI edits (along with LCD/NCD).
For me personally, our EHR does not have software built in, but there are SOME edits that have been manually added. I use Codify (simply because it is what my employer pays for) to check NCCI edits (along with LCD/NCD).
Korbc
Expert
thanks so much!