Wiki Laparoscopic bilateral salpingo-oophorectomy, mini laparotomy

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desireewhite185@yahoo.com

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Hello,
Looking for advice on how to bill this Lap. BSO, mini laparotomy. In order to remove the specimens the doctor had to extend the incision and use his hand to manually remove the specimen. The surgery was done laparoscopically, specimens freed lap. But would not fit in the lap. bag for removal. So he removed all through the extended incision. Not sure if I should still use 58661 or instead use 58720. Thank you for your time and advice, Desiree
 
When a mini-laparatomy is done only to remove the specimen, it does not change the coding.
You would code the laparoscopic procedure in this scenario, as the actual surgery was done this way. If during the surgery, they converted to an open procedure, then you would code for the open as that is how the surgery was completed.
IF significant additional work was performed and documented, you could consider adding modifier -22 on 58661.
Don't forget per CMS (and some commercial carriers), -50 to indicate bilateral is a valid modifier on 58661.
 
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