Wiki TAH-BSO and bilateral pelvic lymph node dissection

[amjordan]

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]

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

 

[garmab06]

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.