Ob-gyn Coding: Ensure You've Got Well-documented Adhesions

By Author: erinarticle
Total Articles: 105
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In a particular scenario, my ob-gyn carried out an "operative laparoscopy adhesiolysis, abdominal myomectomy." How should you report this?


Well, to put it in other words, your ob-gyn carried out laparoscopic lysis of adhesions, then converted to an open myomectomy. For the laparoscopic lysis of adhesions, you should code 58660. In order to report this code, you should ensure that the type of adhesions your ob-gyn addressed is the kind that payers normally pay. If your ob-gyn doesn't describe the adhesions in the op report thoroughly, trying to report the lysis is a waste of your time and a line item on the claim form.


You should either report 58140 or 58146 for the abdominal myomectomy.


While listing the codes on your claim, list 58140 or 58146 first followed by the lysis code (58660). You do not require a separate procedure modifier since you will not find this code combination bundled in the National Correct Coding Initiative (NCCI).


Heads up: See to it that you include V64.41 as a diagnosis for the open procedure in addition to the diagnosis ...
... for the surgery itself.


Remember: If the ob-gyn intended to do a laparoscopic myomectomy and found adhesions but did not remove them laparoscopically, then converted to carry out the abdominal myomectomy, you should bill the myomectomy code (Increased procedural services) with modifier 22 (Increased procedural services) only. Payers will bundle the lysis in this situation.


For further details on this and for other specialty specific articles to assist your ob-gyn coding, sign up for a good medical coding resource like Coding Institute.