Question Laparoscopy help

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My doc performed a Diagnostic laparoscopy with drainage of left ovarian cyst and subsequent left salpingo-oophorectomy. I believe the CPT code's are 58661 and 49322-51 but that word subsequent is bothering me and making me think it's 58800 and 58661. Can anyone help me on this so I can get a better understanding?
 

csperoni

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58800 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach
This would definitely be incorrect if the cyst is drained laparoscopically. You should never use a code for a different approach than what was done, even if that means using unlisted codes.
58661 and 49322 are CCI edits as 58661 is a more extensive procedure than 49322.
IF it were appropriate, 58661 & 49322 could be billed together with -59, -XU, -XS, -XE, -XP.
I do not think it is appropriate in this case. For example, I would bill them together if cyst was drained on the left, and tube removed on right. Or some other situation where the procedures were distinct and separate.
 
Messages
9
Location
Sioux City, IA
Best answers
0
58800 Drainage of ovarian cyst(s), unilateral or bilateral (separate procedure); vaginal approach
This would definitely be incorrect if the cyst is drained laparoscopically. You should never use a code for a different approach than what was done, even if that means using unlisted codes.
58661 and 49322 are CCI edits as 58661 is a more extensive procedure than 49322.
IF it were appropriate, 58661 & 49322 could be billed together with -59, -XU, -XS, -XE, -XP.
I do not think it is appropriate in this case. For example, I would bill them together if cyst was drained on the left, and tube removed on right. Or some other situation where the procedures were distinct and sepa
Ok so I need to do 58667/49322 with 59 and not a 51? Thankyou for taking the time to explain this to me. Also I deleted that other message. Sorry my first time using this.
 

csperoni

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I agree with 58661. Regarding 49322, it would be billed with -59, -XU, -XS, -XE, -XP ONLY IF APPROPRIATE.
Based on this limited information, I do NOT think it would be appropriate. For example, if the cyst were drained in order to facilitate the laparoscopic LSO, the draining is included and is NOT billable separately.
Here is a good article from Palmetto MAC regarding using -59. https://www.palmettogba.com/palmetto/jmb.nsf/DIDC/8EELFC1110~Claims~Modifier Lookup
 
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