TAH-BSO and bilateral pelvic lymph node dissection

amjordan

True Blue
Messages
751
Location
Blue Springs, MO
Best answers
0
I am having one of those moments where my brain is locked.

I just received a OP report with a denial from the insurance company. The codes billed out by the coder were 58150-62 and 38770-5062, they denied 38770-5062 as being inclusive to 58150. Nothing I can find in CCI, CPT or ACOG bundles this. Am I missing something?

The surgery was done for adenocarcinoma of the endometrium. The procedure included at TAH-BSO and they removed the obturator and iliac lymph nodes bilaterally. No omenectomy, or partial vaginectomy was performed. There was no evidence of extrauterine disease present.
 

becca12

Networker
Messages
31
Location
Idaho
Best answers
0
Hello, sometimes individual insurance companies have there own edits. So if I was you I would look on the insurance company website to see if they have there own edits. If they do then you might be able to appeal there decision. I know in the state I live in you can appeal an edit denial and sometimes you can get it paid.

Thanks

Rebecca
 

garcia06

Networker
Local Chapter Officer
Messages
60
Location
Rio Rico, AZ
Best answers
0
if your report reads bilateral removal of lymphs? sometimes the provider report bilateral but in the context of the report they are not removed bilateraly, i notice that the sequence of the modifier on 38770 would be 62-50-51

or would it be best to code 58210 if there is more work involved in the procedure.(radical) it would be best to obtain your provider assistance.
 
Last edited:
Top