Wiki Robot Assisted Partial Bilateral Oophorectomy

[tloeb]

I have a case that the provider performed a partial bilateral oophorectomy due to fertility sparing measures. She had bilateral teratomas that required the provider to excise portions of the ovarian surface. My first thought is that code 58661 would be billed with mod 50 due to the bilateral procedure but would also require mod 52 because the full procedure was not performed as a portion of both ovaries are remaining. However, the provider added a mod 22 statement. Mod 52 and 22 are contradictory so are not appropriate to be used together. Any thoughts? Another option would be to use 58662 but that would not include partial ovarian tissue removal. Mod 22 statement copied below:
Modifier 22
Is indicated for laparoscopic bilateral partial oophorectomies because of the significant increased work required to preserve her ovaries and remove the ovarian tumors. This is related primarily to the size of both ovarian mass. Her morbidly obesity also increased the surgical effort, BMI 51.3. As a result the modifier 22 is indicated.

 

[nielynco]

I have a case that the provider performed a partial bilateral oophorectomy due to fertility sparing measures. She had bilateral teratomas that required the provider to excise portions of the ovarian surface. My first thought is that code 58661 would be billed with mod 50 due to the bilateral procedure but would also require mod 52 because the full procedure was not performed as a portion of both ovaries are remaining. However, the provider added a mod 22 statement. Mod 52 and 22 are contradictory so are not appropriate to be used together. Any thoughts? Another option would be to use 58662 but that would not include partial ovarian tissue removal. Mod 22 statement copied below:
Modifier 22
Is indicated for laparoscopic bilateral partial oophorectomies because of the significant increased work required to preserve her ovaries and remove the ovarian tumors. This is related primarily to the size of both ovarian mass. Her morbidly obesity also increased the surgical effort, BMI 51.3. As a result the modifier 22 is indicated.

Well from a strictly technical point of view, the code 58661 describes "partial or total oophorectomy/salpingectomy" and without further clarification, the partial removal of both ovaries should still qualify for this code. There are various medical definition of a "partial oophorectomy" which includes removal of part of an ovary. Go with 58661-50

 

[tloeb]

Well from a strictly technical point of view, the code 58661 describes "partial or total oophorectomy/salpingectomy" and without further clarification, the partial removal of both ovaries should still qualify for this code. There are various medical definition of a "partial oophorectomy" which includes removal of part of an ovary. Go with 58661-50

I went back and forth with that thinking partial meant One ovary and total meant both, but then wondered if partial could simply mean a portion of the ovary. Thanks for your thoughts and time!