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IUD Removal - Doc removed encapsulated IUD

  1. #1
    Chattanooga, TN
    Question IUD Removal - Doc removed encapsulated IUD
    Medical Coding Books
    Doc removed encapsulated IUD from the distal lower portion or the omentum - laparoscopically. 49402 requires opening the abdomen. The procedure was more than an IUD removal. Any ideas? Thanks!

  2. #2
    How about 58301 Removal of IUD with 22 modifier to show "unusual" procedure? You will have to drop the claim to paper and submit with your op notes.
    Christina Lee Wagner, CPC, CPC-H

  3. #3
    Unhappy Laparoscopy IUD Removal -CPT
    Sorry I did the same question before but I still confused. I am a new coder to the OB/GYN.
    The Doctor removed a Copper IUD laparoscopy because she couldn' t remove the usual way. It was found in the lower peritoneal cavity between the bladder and the uterus and remove it through the trocar. At the same time he found some pelvic adhesions and remove them also.

    Thank you again,


  4. #4
    Milwaukee WI
    Default 49329 Unlisted Procedure
    This isn't my area of expertise, but ...

    I think you're stuck using 49329 Unlisted laparscopy procedure, abdomen, peritoneum and omentum. I'd base my pricing on 49402.

    I'm sure this isn't the answer you were hoping for ...

    If you can post the scrubbed op note it may help experienced members give you a more definitive answer.

    Hope that helps.

    F Tessa Bartels, CPC, CEMC

  5. #5
    Kansas City, MO
    49329 is correct. When selecting a comparable procedure, it all depends on the amount of work it took to remove it. I have seen the following codes recommended for the circumstances listed below.

    Not embedded - 49320
    Embedded or took more work - 49322
    Encased w/lysis of adhesions - 58660

    Some carriers will not allow you to drop to paper on the original submission. You should have a place to add "Claim Note" in your billing system. It helps to add a short note "Laparoscopic IUD removal for an ectopic IUD, similar to code 49320. Op note available on request"
    Angela Jordan, CPC, COBGC, AAPC Fellow
    Senior Managing Consultant
    Medical Revenue Solutions, LLC
    AAPC National Advisory Board - Southwest
    AAPCCA BOD Chair 2012-2013

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