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Wiki CPT help,lscpy to open, LSO & adhesions

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Karen A.

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Pt had pelvic pain, pelvic inflamatory disease & left tubo-ovarian abscess. Surgery began with diagnostic laparoscopy with intention of laparoscopic LSO. Due to extensive inflammation/adhesions found, surgeon converted to open laparotomy. The bulk of the surgery time was spent with lysis of adhesions and irrigating the abdominal cavity. The surgeon dicated the surgery done as: Diagnostic laparoscopy with exploratory laparotomy salpingo-oophorectomy with washout. Is billing this as 58720-22 correct? I am assuming we can not bill for the diagnostic laparoscopy and the lysis of adhesions is bundled withe the open salpingo-oophorectomy code, 58720. This is a self pay patient.
Any comments will be greatly appreciated!
 
Extensive adhesiolysis, involving most of the surgical time can not be waived out that easily by bundling it with the BSO. My feel is to to report the 58660 as a distinct procedure with -59, along with 58720.
Both are separate procedures by their nature and classification.
Some payers do accept some do not. But support with a detailed Op report.
Hope this passes.
Dont forget the V code 64.41
 
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