GYN Oncology

lorilynn7657

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I started coding for a Gyn Oncologist. When she performs a 58150 or 58180, many times patients are sent to her due to extensive adhesions. In many cases, a couple of hours is taken lysing adhesions in order to get to the uterus, so the hysterectomy is the easy part of the surgery. I know I can't bill 44005 with 58150 or 58180, but I'm considering billling the higher RVU surgery, 44005 and perhaps a 22 mod on it indicating more of a procedure than LOA. (?) I realize this would not tell the carrier that a hysterectomy was done, so I wonder what other Gyn Onc coders do in this situation.
thanks!
 

Bready

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She came in for a hysterectomy and had a hysterectomy done. You code the hysterectomy. Your doctor dictates the difficulty of the procedure due to the extensive adhesions found and how much extra time it took to get thru these adhesions. You append modifier 22 to your hysterectomy code and attach the physicians operative note. Maybe the carrier will allow more for the adhesions and maybe not. You may have to appeal the claim if the carrier does not allow for the adhesions.

Unfortunately, surgeons are not always paid for all the extra work or difficulty of a particular surgery.

Good luck.
 
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