Wiki Detorsion of Ovary

ejaquier

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I'm new to coding for gyn services and I cannot find a cpt code that will work for the detorsion of an ovary. Can anyone suggest anything for this? I tried searching in here and couldn't find anything within the last few years. The doctor is wanting to use 58679. TIA!!
 
There is no code to detorse the ovary - laparoscopic or open. Unlisted is correct (58679 if laparoscopic). Whenever using an unlisted code, you should be prepared with a benchmark code. That is, another code somewhat similar that you feel is the same amount of work. For example, 58660, 58662, 58825.
If there was another procedure done at the same time, I would consider -22 on the original procedure and no separate code for the detorsion.
 
Hello, I would like to hear your rational to why we cannot use a benchmark/comparable code 49320 for Lap de-torsion of ovary? To me, 49320 matches better because MD didn't do any surgical procedure like in 58662. I would focus on Laparoscopic, diagnostic- key words and that brings me to 49320 just because it was not a Surgical procedure. What do you think? I will greatly appreciate your rational. Thank you!
49320-Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
58662- Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
OP note:
Procedure(s) and Anesthesia Type: * GYN DIAGNOSTIC LAPAROSCOPY -
.....
Laparoscopy: Using D&G graspers and suction irrigator, the right ovary and fallopian tube were untwisted. Afterwards, there was noted to be improvement in ovary's color, becoming less purple and more pink after un-twisted. After this, the IP and UO ligaments were noted to be in their normal anatomic position without any twisting.
 
Hello, I would like to hear your rational to why we cannot use a benchmark/comparable code 49320 for Lap de-torsion of ovary? To me, 49320 matches better because MD didn't do any surgical procedure like in 58662. I would focus on Laparoscopic, diagnostic- key words and that brings me to 49320 just because it was not a Surgical procedure. What do you think? I will greatly appreciate your rational. Thank you!
49320-Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure)
58662- Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method
OP note:
Procedure(s) and Anesthesia Type: * GYN DIAGNOSTIC LAPAROSCOPY -
.....
Laparoscopy: Using D&G graspers and suction irrigator, the right ovary and fallopian tube were untwisted. Afterwards, there was noted to be improvement in ovary's color, becoming less purple and more pink after un-twisted. After this, the IP and UO ligaments were noted to be in their normal anatomic position without any twisting.
I apologize if it was not clear in my previous answer, but I did not mean you CANNOT use 49320 as a benchmark for unlisted. Unlisted simply means there is no code, and coder (with assistance of clinician recommended) decide which code is a similar amount of work. I simply provided 3 EXAMPLES that depending on the specific case could be used.
Some cases are easier, some harder (physician may remove some adhesions or suture the ovary into the correct placement to prevent a future torsion.)
For most of the cases I've seen, 49320 would be an undervalue of the amount of work. If what you posted is the entire body of the op note, then 49320 may be more appropriate.
I do strongly recommend input from the clinician when using an unlisted if clarification is needed.
 
Thank you so much, Cristine and Cmama12, for your response! I greatly appreciate it. I am still learning and apparently it takes years to master OBGYN. I keep making lots of notes from our Forum with attached files and links- all is very helpful! Like many of us, we tremendously appreciate you sharing your experience with us. I should add Ms. Nielynco as well who helps a lot with our Obstetric questions. Thank you to all of you, our OBGYN Experts! :)
 
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