Wiki Please Help W/ Surg Coding

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dan528i

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Hello,
Can someone please tell me if this is correct:

Doctor was assisting during GYN surg. and I billed the ins. comp the following:
Supracerv.hysterectomy 58180-82 and D&C 59160-82 (DX 666.10-postpartum Hemarrhage)
The ins. comp paid for 58180-82 and denied 59160 as insidental.

Would I be able to appeal w/ mod 51 on 59160?

Thanks in advance !
 
Ok, first off, lets clarify the situation, if I am assuming correctly this patient had a postpartum bleed, the surgeon tried to control the hemorrhage and when that was not possible the decision was made to do the hysterectomy??? is this correct??? if so, the curettage, postpartum (59160) is not billable as it would be incidental to the hysterectomy (58180); the hysterectomy (the greater service) stopped the hemorrahaging; also note, assistance surgeon is not allowed with CPT 59160.

Therefore, in answer to your question, no, you cannot appeal 59160.

Jennifer, CPC
ENT
 
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