Question need assistance or advice on delivery

rockylopez

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Hello. I need to ask for assistance or advice on a charge that an ob doctor is dropped.
op report states REPEAT LOW TRANSVERSE CESAREAN SECTION, BILATERAL SALPINGECTOMY, RIGHT OVARIAN CYSTECTOMY.
patient was 36 weeks and had fetal demise.
The charges that the physician is dropping is
-59618 PR ROUT OB CARE,C-SEC,PREV C-SEC icd 10 O36.4XX0 Maternal care for intrauterine death, not applicable or unspecified
-58700 PR REMOVAL OF FALLOPIAN TUBE icd 10 z30.2 Encounter for sterilization
-58925 PR REMOVAL OF OVARIAN CYST(S) icd 10 d27.0 right dermoid cyst


can someone please tell me if 59618 is billable as patient has a commercial plan and was under global ob care with physician. shouldnt do csection cpt code be 59510
and for the tubal ligation bilateral per op report shouldnt cpt code be 58611?
i agree with 58925 as patient did have removal of right cyst
 

csperoni

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I cannot provide advice regarding the ob care, but can certainly provide information regarding the bilateral salpingectomy for sterilization. Per ACOG, the correct code for salpingetomy for sterilization at time of C-Section is 58611 not 58700 even though they are removing the tube, not ligating/transecting. I agree that 58925 is correct for the right ovarian cystectomy.
 

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nielynco

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Guadalupita, NM
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Hello. I need to ask for assistance or advice on a charge that an ob doctor is dropped.
op report states REPEAT LOW TRANSVERSE CESAREAN SECTION, BILATERAL SALPINGECTOMY, RIGHT OVARIAN CYSTECTOMY.
patient was 36 weeks and had fetal demise.
The charges that the physician is dropping is
-59618 PR ROUT OB CARE,C-SEC,PREV C-SEC icd 10 O36.4XX0 Maternal care for intrauterine death, not applicable or unspecified
-58700 PR REMOVAL OF FALLOPIAN TUBE icd 10 z30.2 Encounter for sterilization
-58925 PR REMOVAL OF OVARIAN CYST(S) icd 10 d27.0 right dermoid cyst


can someone please tell me if 59618 is billable as patient has a commercial plan and was under global ob care with physician. shouldnt do csection cpt code be 59510
and for the tubal ligation bilateral per op report shouldnt cpt code be 58611?
i agree with 58925 as patient did have removal of right cyst
Christine is spot on with her reply to the use of 58611 and 58925. And yes, if this physician or this physician's group provided all of her ob care and this was a VBAC delivery (ie, she was allowed to labor before the decision was made that they had to repeat the cesarean), the correct code would be 59618. If this was simply a planned repeat cesarean, the global code would be 59510, not 59618. You will have to look at the delivery notes to be sure.
 
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