Wiki Laparoscopy Vs Laparoscopy Salpingo-oophorectomy

[such78]

The surgeon removed the right ovary and tube under laparoscopy. Because of the massive of size, the surgeon had to convert the laparoscopy to laparotomy to remove out the specimen. I am thinking to assign CPT as laparoscopy for salpingo-oophorectomy since that was how organs excised. Please advise.

 

[csperoni]

For laparoscopic converted to open, you code as open.
However, your statement says "convert...to remove out the specimen". If the surgery was performed laparoscopic, but the specimen was too large to fit through the laparoscopic holes, surgeons will sometimes do what my surgeons call a "mini laparotomy" ONLY TO REMOVE THE SPECIMEN. They are not performing any of the surgery through that opening. In those situations, I use the laparoscopic code as that is how the surgery was performed.
If the specimen was too large or complex, or any other reason, and they opened the patient and did the remainder of the surgery open, then only the open code is used.

 

[such78]

For laparoscopic converted to open, you code as open.
However, your statement says "convert...to remove out the specimen". If the surgery was performed laparoscopic, but the specimen was too large to fit through the laparoscopic holes, surgeons will sometimes do what my surgeons call a "mini laparotomy" ONLY TO REMOVE THE SPECIMEN. They are not performing any of the surgery through that opening. In those situations, I use the laparoscopic code as that is how the surgery was performed.
If the specimen was too large or complex, or any other reason, and they opened the patient and did the remainder of the surgery open, then only the open code is used.

Thanks for your valuable feedback. I have doubted myself, I can finalize codes now.