58670 question

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New Hartford, CT
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Dr removed right ovary and performed fulguration of both oviducts. 58661 and 58670 were both billed, 58670 denied as inclusive. My question is....when is it appropriate to append modifier -59 to this scenario? Thanks.
 

ajs

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Tacoma, WA
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Dr removed right ovary and performed fulguration of both oviducts. 58661 and 58670 were both billed, 58670 denied as inclusive. My question is....when is it appropriate to append modifier -59 to this scenario? Thanks.
You could certainly use the 59 modifier on the 58670 in this case. There is no guarantee the insurance carrier will agree, but the procedure to fulgurate the oviducts is somewhat different than removal. The 58661 is for removal of one or both ovaries and their accompanying fallopian tubes. Neither tube was removed, they were fulgurated, so I would code the claim with 58661 and 58670-59. Send an appeal with a copy of the operative report.
 
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