Wiki what cpt codes would I bill for resection of endometriotic implants, ovarian transposition & robotic asst. total laparoscopic hysterectomy bil. salpin

[drkstrebel@whasn.com]

Can anyone please help with the above question?

 

[csperoni]

Typically, you will see better responses to your posts if you indicate what codes you are considering and why.

1) Total laparoscopic hysterectomy with bilateral salpingectomy = 58571 if uterus is <250g and 58573 if >250g.
You could consider S2900 for the robot, but none of my payors will reimburse for it.
2) Resection of endometriotic implants. ASSUMING this was also laparoscopic, 58662.
3) Ovarian transposition. ASSUMING this was also laparoscopic, there is no code for this. Depending on documentation and amount of work involved, you could consider unlisted 58679 or adding -22 to the primary procedure.

Ensure you are matching the appropriate diagnosis to each procedure. While 58571/58573 and 58662 are not NCCI edits, some payors may bundle and require a modifier. By Medicare guidelines, not required.
From my experience, ovarian transposition is typically done for cancer patients who will be receiving radiation. In which case, I would ask was it truly endometriosis implants, or possible debulking of a malignancy? If so, the coding would change.

 

[Cmama12]

I recently have seen several providers regularly tack the ovaries post hysterectomy - I am assuming to prevent torsion. I would not bill anything extra in this case vs a true ovarian transposition in a gyn onc case.

 

[drkstrebel@whasn.com]

I recently have seen several providers regularly tack the ovaries post hysterectomy - I am assuming to prevent torsion. I would not bill anything extra in this case vs a true ovarian transposition in a gyn onc case.

Thank you

 

[natashalage]

I agree with everything what was said above, I am still learning. I would like to add that you can also post your question to a specifically designated OBGYN specialty Forum where you can find so much valuable information. I do remember 'transposition of ovaries' was discussed there at length. You can also use Search field to look for your specific topic. Thank you to our OBGYN experts Csperoni, Cmama12 and Nielynco.