Appropriate codes for dx lap with revision of vaginal cuff

[cgarcia@jpbmd.com]

Hello everybody. My provider is needing me to verify some codes for benefit purposes on a procedure that is being performed for our patient.
Procedure would include a dx laparoscopy (with possible lysis of adhesions). He is also looking to perform a revision of vaginal cuff and excision of granulation tissue. I'm sure the dx lap i would verify the 49320. I'm stuck on the second procedure. 57200 doesn't seem to fit quite right.

 

[csperoni]

This Coding Alert article should point you in the right direction.

https://www.aapc.com/codes/coding-newsletters/my-ob-gyn-coding-alert/gynecology-keep-modifier-78-handy-for-your-vaginal-cuff-repair-claims-162935-article?srsltid=AfmBOoqnvZ3ZPIfTJZ01wqvJb8_PAnYGakSf7rMbIYY-UiAl9sXEV6x_

This prior post and discussion also discusses the excision of granulation tissue:

https://www.aapc.com/discuss/threads/excision-of-granulation-tissue.179612/?srsltid=AfmBOop913zUxQI9IsNl_xZ5gKjihtrMsnRMchOl0mZNDGgUUYGOYCct

It is very likely you are looking at unlisted, and will need to determine (with your provider's input) what other code to compare as a similar amount of work.

 

[Cmama12]

Hello everybody. My provider is needing me to verify some codes for benefit purposes on a procedure that is being performed for our patient.
Procedure would include a dx laparoscopy (with possible lysis of adhesions). He is also looking to perform a revision of vaginal cuff and excision of granulation tissue. I'm sure the dx lap i would verify the 49320. I'm stuck on the second procedure. 57200 doesn't seem to fit quite right.

Also, while you can give an approximation, you won't really be able to determine this ahead of time because the comparable will depend on what approach and manner of repair he ends up using. We have a handful of different codes for vaginal cuff repairs, as well as just removal of granulation tissue. If the whole thing is done laparoscopically, then you may just have one unlisted code.

 

[cgarcia@jpbmd.com]

Thank you both. I'll look into those articles shared. This surgery also comes from issues following a hysterectomy that was performed at the end of last year.