# 58662, 58925 or both



## coders_rock! (Mar 27, 2013)

Please help w/CPT codes and your rationale if possible. Thank you.

OPERATION: LAPAROSCOPIC BILATERAL OVARIAN CYSTECTOMY.

SPECIMENS SENT:
1.  LEFT OVARIAN CYST WALL.
2.  RIGHT OVARIAN CYST.

INDICATIONS: I NCIDENTAL FINDINGS, ON EXAM OF BILATERAL LARGE OVARIAN CYSTS.

PROCEDURE: 
Bivalve speculum was placed in patient's vagina.  Manipulator was placed in the uterus and inflated without difficulty.  Attention was then drawn to the patient's abdomen.  A skin incision was made at the base of the umbilicus using the scalpel.  The trocar was placed in the umbilicus intra-abdominal, placement was confirmed. The patient was then placed in deep Trendelenburg position.  There were mild adhesions by the liver and mild adhesions of the adnexa walls.  Two additional trocars were then placed, a 5-mm trocar superior and medial to the right anterior iliac spine, a 5-mm trocar was placed in similar fashion.  A 10-mm trocar was placed in the left lower quadrant.  At that time, the ovarian wall was incised and the cyst was scored from the ovarian tissue.  The cyst was ruptured and thick green fluid was noted consistent with a dermoid cyst.  The cyst wall was removed from the normal ovarian tissue and placed in the anterior portion of the abdomen above the uterus.  

Attention was then focused on the right ovary.  The ovarian wall was incised again and the approximately 4-5 cyst walls were removed.  A Endocatch bag was placed through the 10-mm ports and the cysts were removed.  The left cyst was removed first followed by the right cyst in the same fashion.


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## singlemisfit (Mar 27, 2013)

I have billed this multiple times (multiple payers) without issue in my >10 years OB/GYN specialty work experience: 
58662 -LT, 58662 -51,RT
51 modifier instead of 59 since same surgical approach but different organ. 59 would not be appropriate in this case. You will see a 50% reduction in the allowable for the 2nd procedure, but justifiably so.


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## Emmy1260 (Mar 28, 2013)

NCCI edits show that 58925 is a component of 58662. 58662 is for the laparoscopic procedure. 

58662 is not stated as unilateral or bilateral. I defer to 'singlemisfit' for the RT/LT and modifier suggestion.


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