Question laparotomy, detorsion left ovary, left ovarian cystectomy, left salpingectomy

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Hello,
I am hoping to get some advice coding this surgery.
The doctor performed laparotomy, de-torsion left ovary, left ovarian cystectomy, left salpingectomy.
Laparotomy- the ovary had a large cyst and was high in the abdomen. The ovary was de-torsed with three turns.
There was a large cystic structure that was removed and the left fallopian tube as well.
I was thinking 58700 for the left salpingectomy ICD 10 N83.512, N83.8 and 58925 for the cystectomy, N83.292.
Thanks, Desiree
 
Last edited:

csperoni

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For CPT:
One thing you do need to keep in mind is the "separate procedure" designation on 58700. While these codes do not hit NCCI edits, some carriers may not pay them together.
I would also check that it was only the ovarian cyst removed without any ovarian tissue. It is possible 58720 is more accurate if there was ovarian tissue excised.
Depending on the amount of work involved in the ovary being high in the abdomen and what was required to detorse the ovary, you might consider modifier -22. If there was a significant amount of additional work beyond what is being described in the CPT billed, AND it is documented, -22 may be considered.
For ICD-10:
N83.512 Torsion of left ovary and ovarian pedicle seems correct
N83.292 Other ovarian cyst, left side - while not necessarily incorrect, I wouldn't use "other cyst" unless the cyst is described in more detail somewhere else. I would use N83.202 Unspecified ovarian cyst, left side based on the very limited documentation provided as the cyst is not described at all, other than knowing it's on the left ovary.
N83.8 Other noninflammatory disorders of ovary, fallopian tube and broad ligament. I would question what you are using this for. All we know from above is that there is a left ovarian cyst and torsion. It is possible it is appropriate, but would require more information.
 
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