Wiki Laparoscopic hysterectomy with endometriosis excision

[Heinzjulie]

Can anyone confirm if you can bill for both a lap hysterectomy with endometriosis excision within the same procedure? I have read that some are billing for both codes but then I also encountered some information that the endometriosis excision would be considered the same as lysis of adhesions and only billed if the documentation supports adding the 22 modifier.

Thank you

 

[Cmama12]

There are no edits for those codes. We bill both if documentation supports.

 

[natashalage]

From ACOG, it's allowed.
"ANSWER:
Laparoscopic destruction of endometriosis (CPT code 58662) could conceivably be billed during the same operative session as CPT code 58570. However, the documentation in each particular operative note must be sufficient enough to support the billing of 58662.

The documentation of the endometriosis destruction found in the “Description of Procedure” is, “Foci of endometriosis was destroyed.” To bill for 58662, substantially more information is needed, such as a description of the endometriosis and its removal, its size, its type (if known), and the specific method used to destroy the endometriosis. More importantly, there is no clear indication as to why the removal of the endometriosis was medically necessary, as there is no mention of pain, or any other symptomology commonly associated with endometriosis. Based on the brief description and the lack of indication noted, it seems that this was either an incidental or prophylactic procedure and, therefore, would not be separately billable."