Start with the Hysteroscopy codes:
58558 Hysteroscopy D&C, 58561 Hysterscopy w/myomectomy - when you check CCI edits these codes are clear and can both be billed.
Next the Laparascopy, Laparotomy and Abdominal myomectomy:
49320 Dx Laparascopy, (no code for mini laparotomy), 58140 or 58146 Abdominal myomectomy (depending on number or size) - check the CCI edits and find you can bill these together but you will need a modifier 59 on the 49320 and also the dx code that shows the procedure was coverted from laparoscopy to open.
Check the CCI edits for all the codes:
58558, 58561, 49320, and 58140 and you will see that you will also have to add a modifier to 58561 to show that myomectomies were done both hysteroscopically and abdominally.
Then you put them in order of RVU on your claim so it would look like this:
make sure you attach to appropriate dx codes to the procedures. Remember that you still may not get reimbursed on all the codes, some payers may have different bundling edits.
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