Wiki needing CPT code assistance - abdominal washout

[dkeversmiles2]

Hi, I need to Pre-Cert for Robotic Bilateral Salpingectomy, Rt. Ovarian Cystectomy vs Oophorectomy, Appendectomy,. excision and fulguration of endometriosis, abdominal washout.
I am comparing with another coder....her response was 58960.
I am wanting to use 58670, 49084 or 58720, 49084.

I need assistance with this please.
Thank you,

 

[csperoni]

58960 is specifically a staging procedure after another surgery that diagnosed ovarian, tubal or primary peritoneal cancer. It does not sound like the surgery you briefly describe.
58670 is laparoscopic fulguration of oviducts, which does not seem correct either.
With the information provided, it seems like the physician is unsure between 1) laparoscopic BS, ovarian cystectomy or 2) open oophorectomy, appendectomy, excision of endometriosis, abdominal washout.
1) 58662 laparoscopic ovarian cystectomy
58661 laparoscopic bilateral salpingectomy
2) 58940 oophorectomy
22900-22903 for excision of endometriosis abdominal wall
44955 appendectomy only if not incidental
49084 peritoneal lavage

For the purposes of pre-cert, I instruct my staff to get authorization for whatever the surgeon lists first. If at the time of surgery, he/she needs additional procedures, or to convert to open, we bill with the same auth # for the surgery that actually took place.
Hope this helps!

 

[Anastasia]

Per ACOG, 49084 is not performed via a laparoscope. 58662 is used for excision/fulguration of endometriosis; it is also be used for ovarian cystectomy. 58940 is an open procedure; 58661 for laparoscopic oophorectomy/salpingectomy.

 

[fwnewbie]

Unless the "abdominal washout" is done for a specific reason, like cancer, infection or caustic substance, I think what is described is just considered peritoneal hygiene and is a standard cleansing method. Like the dentist having you rinse to clear filling material from your mouth. This is only my opinion.