Go Back   AAPC Forum > Medical Coding > General Discussion
Forum Rules FAQ Members List Calendar Search Today's Posts Mark Forums Read

Thread Tools
Old 04-14-2009, 08:15 PM
tammy creasy tammy creasy is offline
Join Date: Apr 2007
Location: Canton
Posts: 6
tammy creasy is on a distinguished road
Wink Diagnostic Laparoscopy and Lysis Adhesions

I am looking for direction to properly code Diagnostic Laparoscopy and Lysis of adhesions. The preoperative diagnosis is pelvic pain. The postoperative diagnosis is bowel adhesions. The physician is OB-GYN. The procedure is started and while the surgeon is there he encounters bowel adhesions. I know that it can't be charged as 49320 and 44180 for any reason, but if lysis of these adhesions are done can the main procedure now become lysis of bowel adhesions with these dianosis. I need solid direction if the physician can't charge this, so I can address the situation. I thought of possibly changing the procedure code to 58660, but even with that I am questioning myself.
Thanks for any help
Reply With Quote
Old 04-14-2009, 08:41 PM
CindyMason CindyMason is offline
Join Date: Apr 2007
Posts: 1
CindyMason is on a distinguished road
Wink Laparoscopy w/lysis of adhesions

I work for a reproductive endocrinologist and he does these all the time, so we're pretty used to coding them.
Okay, first of all, exactly what does he mean by bowel adhesions. What I mean is, exactly where did he see the adhesions. If it's in the pelvic peritoneum (peritubal or tubo-ovarian), which it probably is, then your ICD-9 code is 614.6 (pelvic adhesive disease). Otherwise, you might have to look at 614.7 or .8, but the insurance will probably ask for the op report because they are rather unspecified. I would also include the pelvic pain (625.9) because he is treating that.
As far as the CPT code is concerned, you have two options and it kind of depends upon where the adhesions were as well. Look at 58660 and
58662. If the lesions are around the ovary, pelvic viscera, or peritoneal surface, then use the 58662, otherwise go with the 58660. The RVU is a little higher for the 58662, but not much.
You might need to have your doc do an addendum to the op report that makes things a bit clearer.
If you have an '09 coding companion for OB/GYN, it has some really great explanations for these procedures.
Reply With Quote

Thread Tools

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off

Disclaimer: Although AAPC staff members will monitor these forums periodically, we cannot be responsible for the information posted herein, nor guarantee its accuracy. Our members may discuss various subjects related to medical coding, but none of the information should replace the independent judgment of a physician for any given health issue. Please note that the opinions expressed here do not necessarily reflect those of AAPC.

All times are GMT -6. The time now is 09:51 AM.

Powered by vBulletin® Version 3.8.1
Copyright ©2000 - 2015, Jelsoft Enterprises Ltd.
Copyright ?2015, AAPC