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**HELP 58660 and 58661??**

  1. #1
    Default **HELP 58660 and 58661??**
    Medical Coding Books
    My doctor wants 58660,59 coded with 58661 on an extensive surgical procedure. Each code was done on a separate side and 58660 is not getting paid due to NCCI. Is this a simple fix and can I just use LT and RT modifiers?

  2. #2
    Default
    The coding guidelines are simple in this case. There is no such thing as a (Bilateral Laparoscopy). If the physician wants to receive reimbursement for the extensive lysis of adhesions, then you need to code 58660-22. The -22 modifier is significant for physicians who need reimbursement for extra time spent in the OR due to extensive adhesions.

    I did not see in your question, did the physician also remove the tubes and ovaries during this procedure or, was it just a laparoscopy for lysis of adhesions?

    If the physician performed the removal of tubes and/or ovaries you will code the 58661-22 for increased services.

    Hope this helps!!!!
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  3. #3
    Default
    Quote Originally Posted by Amy Pritchett View Post
    The coding guidelines are simple in this case. There is no such thing as a (Bilateral Laparoscopy). If the physician wants to receive reimbursement for the extensive lysis of adhesions, then you need to code 58660-22. The -22 modifier is significant for physicians who need reimbursement for extra time spent in the OR due to extensive adhesions.

    I did not see in your question, did the physician also remove the tubes and ovaries during this procedure or, was it just a laparoscopy for lysis of adhesions?

    If the physician performed the removal of tubes and/or ovaries you will code the 58661-22 for increased services.

    Hope this helps!!!!
    Amy - THANK YOU this is phenomenally helpful. To answer your question, yes she did remove one tube and ovary. She went in to perform 58660 originally and was successful on the left side. However, the right side was SO full of damaged tissue and scarring that she was unable to precisely locate adhesions. She removed the ovary and tube on the right side only. She did spend about 3 hours doing what was intended to be a 30 min procedure.

    Would it be correct to ask for payment on both? Also, if I understand you correctly, I would probably have to remove the 59 and get it corrected to a 22 modifier and then add the 22 to 58661 as well?

  4. #4
    Default
    Then you would only code the 58661-22 for the whole procedure.
    Amy Pritchett,
    BSHA, CPC, CPMA, CPC-I, CDEO, CANPC, CEDC, CASCC, CRC, CMDP, CMPM, CCS, CMRS, C-AHI, ICDCT-CM, ICDCT-PCS
    2017-2018 Secretary of Local Mobile AAPC Chapter
    2015-2016 President of Local Mobile AAPC Chapter

  5. Default
    According to the Physician Fee Schedule, 58661 does take laterality modifiers -RT and -LT The 58660 does not.
    So if the surgeon removed the ovary and tube on the right, code 58661 -22 for the additional work and time and -RT for the right side. You may already know this but for the -22 modifier you'll need to drop the claim to paper and send the operative report with the claim. Hope this helps.

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