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Help! - endometriosis via laparoscopy

  1. Question Help! - endometriosis via laparoscopy
    Medical Coding Books
    fulgrated endometriosis via laparoscopy 58662 and then ovarian drilling was then performed on the right ovary due to the sclerotic changes that were evident and there was clear fluid that was removed.

    This completed the procedure. The CO2 was removed, as were the laparoscopic instruments.

    58679 (unlisted) compare to 58970 for the ovary drilling??? thanks!

  2. Default
    This is from "Pink Sheets" March 2009:

    Unlisted code your best bet
    for open ovarian drilling
    Question: The ObGyn uses Endoshears and cautery
    on each ovary to drill six small holes in each ovary
    and also release some fluid from polycystic cysts. A
    total abdominal hysterectomy also was performed.
    I am not sure whether to report the procedure with
    58805 (drainage of ovarian cysto[s], unilateral or
    bilateral [separate procedure]; abdominal approach)
    because the description states that the fluid is removed,
    but in this case the fluid was only allowed to drain and
    was not aspirated from the cavity.
    Answer: Ovarian drilling also is known as ovarian
    electrocautery, which is a form of fulguration (def:
    the destruction of tissue, usually malignant tumors,
    by means of a high-frequency electric current applied
    with a needlelike electrode). Based on the information
    given, we can assume the ovarian drilling was
    performed via an open approach, since a TAH also was
    performed. Therefore, even though ovarian drilling is
    most typically performed laparoscopically, code 58662
    (laparoscopy, surgical; with fulguration or excision
    of lesions of the ovary, pelvic viscera or peritoneal
    surface by any method) does not apply in this case,
    since the approach wasn't laparoscopic. Note: For laparoscopic
    ovarian drilling, ACOG recommends 58662
    One possibility is 58805, but unfortunately, this
    code is generally understood to include aspiration of
    the fluid in the ovary, but in the reader's case, the fluid
    was released (i.e., drained), but not aspirated. Also
    note that 58805 is classified as a separate procedure
    in CPT, which means that when it is reported with
    another procedure performed in the same general anatomic
    area, it's included and won't be paid separately.
    In this case, therefore, you should consider reporting
    unlisted code 58999 (unlisted procedure, female
    genital system [nonobstetric]) for the ovarian drilling.
    Another alternative is 49203 (excision or destruction,
    open, intra-abdominal tumors, cysts or endometriomas,
    1 or more peritoneal, mesenteric or retroperitoneal primary
    or secondary tumors; largest tumor 5 cm diameter
    or less).

  3. Talking
    Thanks imjsanderson...If it is possible could you fax me the pink sheet at 574-247-3350 attn: Jamie for future use....Thanks for the help info!

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