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Help please,
I am looking for assistance with Ureterolysis coding.
My provider has written. I am not sure how to code this paragraph. There is a lot going on here.
I know there Ureterolysis is 50715 and I have N13.5 for the retroperitoneal fibrosis, N80.9 for Endometriosis but for the rest I am lost.

"Pararectal Dissection with Ureterolysis due to retroperitoneal fibrosis & decompression of the inferior hypogastric nerve & resection of cardinal ligament/uterosacral and Rectovaginal deeply infiltrative endometriosis"
 
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Was there another surgery (like a hysterectomy) done at this same time?
If so, the resection of cardinal ligament (and broad ligament, and round ligament, and uterosacral ligament, etc) is part of a hysterectomy. I don't recall ever seeing the above done without a hysterectomy.
 
After a brief review, I would code this as:
50949 N13.5 {for laparoscopic ureterolysis for retroperitoneal fibrosis. request to value as 50715 open ureterolysis for retroperitoneal fibrosis}
58662-XU N80.9, N83.202 {for laparoscopic excision of endometriosis and laparoscopic left ovarian cystectomy}
64722 R10.2 {for decompression of hypogastric nerve assuming this code is appropriate for laparoscopic. My gynonc physicians have never done this procedure and I am not experienced with coding it}
58350-XU POSSIBLY. I'm not certain exactly why the physician performed the chromopertubation. If it was just to check there was no tube damage during the surgery, not billable similar to cystoscopy often done with laparoscopic hysterectomy. If it was done because there was infertility, or due to the extensive endometriosis, then I would bill for it.

Please note 50715 is not appropriate as the entire procedure was done laparoscopically.

Hope that helps!
 
After a brief review, I would code this as:
50949 N13.5 {for laparoscopic ureterolysis for retroperitoneal fibrosis. request to value as 50715 open ureterolysis for retroperitoneal fibrosis}
58662-XU N80.9, N83.202 {for laparoscopic excision of endometriosis and laparoscopic left ovarian cystectomy}
64722 R10.2 {for decompression of hypogastric nerve assuming this code is appropriate for laparoscopic. My gynonc physicians have never done this procedure and I am not experienced with coding it}
58350-XU POSSIBLY. I'm not certain exactly why the physician performed the chromopertubation. If it was just to check there was no tube damage during the surgery, not billable similar to cystoscopy often done with laparoscopic hysterectomy. If it was done because there was infertility, or due to the extensive endometriosis, then I would bill for it.

Please note 50715 is not appropriate as the entire procedure was done laparoscopically.

Hope that helps!
THank you so much
 
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