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Wiki Billing/Coding CPT 49000 with 58720 & 58558

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erthsvr

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Can anyone help? I have a question where an insurance company is denying CPT 49000 (Exploratory laparotomy, exploratory celiotomy with or without bopsy(s) (spearate procedure). The bill also includes CPT 58720 (Salpingo-oopherectomy, complete or partial, unilateral or bilaterl (separate procedure) and CPT 58558 (Hysteroscopy, surgical; with sampling of enometrium and/or polypectomy, with or without D & C.

If the notes show that the original procedure was just for exploration and when they got in there and found that they needed to do the other 2 procedures, can these all be billed together?

Thanks,

Heather MacPherson, LPN, CPC, CPC-H
 
No

The exploratory lap can be billed ONLY when it is the only thing done.

If, as a result of the exploration, you discover a problem and go on to surgically correct it (as happened in your case), you code only the surgery that was actually performed (excision, resection, repair, etc)

Hope that helps.

F Tessa Bartels, CPC, CEMC
 
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