Wiki OB Gyn Surgery Coding Help

[Tiffaney]

I need coding help with 2 cases

My providers did a Laparoscopic Left Salpinectomy, and a Right Tube transection (tube not removed). I am being told this falls under 58661. Is this Correct or would I bill 58661 and 58670 (for the tube transection)? When answering can you also put the rationale for the answer?

2nd Case - Laparoscopic Salpingectomy removed and removal of a Right Ovarian Mass (not the ovaries just the mass) I know 58661 but also 49321? When answering can you also put the rationale for the answer?

Thank you
Tiffaney

 

[csperoni]

58661 is "Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)"
58670 is "Laparoscopy, surgical; with fulguration of oviducts (with or without transection)"
49321 is "Laparoscopy, surgical; with biopsy (single or multiple)"

CASE 1: 58661 & 58670 seem to exactly describe what was done. 58670 is a column 2 CCI edit with 58661 (which means you may use a modifier if appropriate to override the edit). Since in this case, the procedures are on different sides, I would use modifier -XU as well as -LT & -RT respectively.

CASE 2: 58661 is for the laparoscopic salpingectomy. Please note IF it was bilateral, -50 is appropriate (laterality not indicated in your post). For laparoscopic removal of an ovarian mass, there is a better code of 58662 "Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method". They are not CCI edits.