Wiki myomectomy during c-section

[Airam0912]

My doctor performed a myomectomy during a c-section. I'm not sure if I should bill the myomectomy as 58140 w/ mod 52 and 59. 52 because incision had already been made for C-section. Or should I bill this w/ an unlisted code 59899? Also if I bill w/ code 58140 am I allowed to also bill out assistant surgeon fees on both the c-section and the myomectomy or just one? Help

 

[bonzaibex]

The c-section and the myomectomy are not bundled, so you shouldn't need a 59 modifier. I think you could bill out both without putting a 52 modifier on the 58140. Your payer is going to reduce the reimbursement based on multiple procedure rules anyway. The only modifier you should need (if any) would be a 51 on the myomectomy code.

As for assistant surgeon, both codes are eligible for an assist, so if you are also billing for the assist, I would bill both out with the appropriate assistant surgeon modifier.

At least that's my logic....

Becky, CPC

 

[amy_mousie]

I agree with Becky -

Bill with modifier 51 for multiple procedures as most insurance are following Medicare guidelines and could reject for that.

As for the Assistant Surgeon, I would use modifier 80.

Amy, CPC CMBS CCP

 

[Airam0912]

Thanks for your help. That sounds right to me.