Hello to All,
After reading the article in AAPC magazine June 2024 " Weigh In on Hysterectomy Coding" page 36, I recalled this conversation on Mini laparotomy for removing a large organ/specimen Only. I would like to bring to your attention that there is a possible error in coding OBGYN case where the surgeon did the intended LTH but because the the 'uterus was too large to remove vaginally" MD did a mini laparotomy. The author telling us to code it as Open surgery 58150. Could you please confirm that 58150 open is incorrect code and if yes, who should we contact to? If I am wrong, then I apologize. Thank you to all of you.
"Case example: A patient with menorrhagia and an enlarged uterus (874 grams) presented for a robotic assisted total laparoscopic hysterectomy with bilateral salpingectomy. After the uterus, cervix, and bilateral fallopian tubes were amputated with electrocautery, an endo catch bag was placed through the vagina. However, the uterus was too large to remove vaginally so the decision was made to proceed with a mini laparotomy. A separate Pfannenstiel incision was made and carried down to the underlying fascia. The uterus and endo catch bag were then brought to the incision and delivered through the mini laparotomy.
For this case example, you would be correct to assign CPT® 58150 Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s), for the hysterectomy requiring a separate incision to remove the specimen. The laparoscopic procedure was converted to an open procedure; therefore, a code for the open procedure is reported. This guidance is provided within the
NCCI Policy Manual, Chapter 1.
https://aapcpublishing.s3.amazonaws.com/AAPCtheMagazine/June2024/index.html?_gl=1*oe3u4j*_ga*MTQzODM3NTAwMy4xNjQ5MDk3NzI4*_ga_YCM4N7Z8H4*MTcxNjg0MDI2NS4xMzMuMS4xNzE2ODQwODk5LjM0LjAuMA