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CPT 58660, 58661 and 58662 together

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wendy7879

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Scurry, TX
I know some of these codes are bundled but unsure how to correctly bill the following op report. Diagnostic Laparoscopy, lysis of adhesions, radical excision of endometriosis, fulguration of endometriosis and a right salpingo-oophorectomy?
 
58660 for the lysis of adhesions is a NCCI column 2 edit for both 58661 and 58662. Basically, lysis of adhesions is included in almost all surgeries, whether laparoscopic or open. If the lysis of adhesions is extensive, and documented as such, then sometimes -22 is warranted on the main procedure.
I would code this as:
58662
58661-XU-RT
While the 58661 is not an edit, many carriers do want to bundle it. I would also ensure I have separate diagnoses (assuming warranted) for each. I am also assuming all procedures were laparoscopic and patient was not converted to open (not 100% clear from your post, but seems very likely).
 
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