Anatomical Location Vital For Myomectomy Claims

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Figuring out which myomectomy code you will report depends on three factors: First the approach the ob-gyn uses, the number of myomas, and their weight. Here's how to translate this information into the proper CPT code every time.


Remember: If your ob-gyn carries out a hysterectomy, you won't report the myomectomy separately.


Look into myomas and their types


When your ob-gyn carries out a myomectomy, he's removing myomas or uterine fibroid tumors. Understanding what type they are will help you to find out your myomectomy code.


About Myomas: Also known as uterine fibromas, myomas are the most common growth of the female genital tract. They are round, firm, benign masses of the muscular wall of the uterus and are composed of smooth muscle and connective tissue.


Are you aware? Often myomas cause or are coincidental with abnormal uterine bleeding, pressure or pain. They're also one of the most common factors why women in their 30s and 40s have hysterectomies.


But then women who want to have children in the future ...
... or simply don't want their uterus removed look for alternative solutions. The following procedures describe abdominal, vaginal, and laparoscopic approaches.


Differentiate two abdominal myomectomy codes


First and foremost, take a look at the abdominal approach. When the ob-gyn carries out an abdominal myomectomy, he surgically removes the myoma from the uterus through an incision in the abdomen. For this procedure, you will report either 58140 or 58146.


Catch this: These codes differentiate between the number of myomas (58140 for one to four; 58146 for five or more) and the total weight of intramural myomas (58140 for total weight of 250 grams or less; 58146 for total weight greater than 250 grams).


Do not forget vaginal myomectomy


Secondly, a vaginal approach means a code of its own. You will report 58145 for a myomectomy via a vaginal approach.


Get to know these laparascopic myomectomy basics


In the end, you have got two laparoscopic approach myomectomy codes. A laparoscopic myomectomy is a less invasive procedure than the abdominal myomectomy. This approach is normally an option for women who have conditions that preclude the vaginal route while still enabling them to avoid major abdominal surgery. Normally, pedunculated myomas are the easiest for ob-gyns to remove laparoscopy; however ob-gyns will also use this approach for subserous myomas. For this procedure, you will use either 58545 or 58546.


Difference: You will use 58545 when the ob-gyn removes one to four intramural myomas with a total weight of 250 grams or less, and you will report 58546 when the ob-gyn removes five or more intramural myomas or intramural myomas with a total weight more than 250 grams.


Stay away from myomectomy codes with a hysterectomy


When your ob-gyn carries out a hysterectomy, both the laparoscopic and open excisional myomectomies are inherent components. Payers will think about the removal of the myomas before the removal of the uterus as an inclusive component of the vaginal and laparoscopic hysterectomy procedure codes 58260-58294, 58541-58573) and the total abdominal hysterectomy and radical pelvic exenteration codes (58150-58240). As such, you shouldn't report the removal of myomas separately to the hysterectomy procedure codes.


For more specialty-specific articles to assist your ob-gyn coding, sign up for a good Medical coding resource like Coding Institute.