# Laparosopic Trachelectomy



## Lbooth110 (Dec 13, 2011)

Our doctor performed a Lap Trachelectomy  with a BSO...... She has requested that I bill out a  58661 plus a  Lap trachelectomy.   My first question is : there is not a code yet for the Lap Trachelectomy and my second question is  even if there was  a code should I only bill the Lap BSO? In the CPT book the 58661 is for adnexal, tubes and or ovaries no where does it include cervix....thank you in advance for all your help!!


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## ajs (Dec 13, 2011)

lisabooboo said:


> Our doctor performed a Lap Trachelectomy  with a BSO...... She has requested that I bill out a  58661 plus a  Lap trachelectomy.   My first question is : there is not a code yet for the Lap Trachelectomy and my second question is  even if there was  a code should I only bill the Lap BSO? In the CPT book the 58661 is for adnexal, tubes and or ovaries no where does it include cervix....thank you in advance for all your help!!



Did the patient previously have a supracervical hysterectomy and now the doc is taking out the cervix later?  Or is this just removal of the cervix but the uterus is left in place?  

When you look at the operative report, is any part of the procedure accomplished vaginally?  Depending on the documentation, you could bill the Lap BSO 58661 and then use 57530 with a 59 modifer (unless it is just the cervical stump then use 57550), otherwise you will have to bill an unlisted laparoscopy code.


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## Lbooth110 (Dec 14, 2011)

ajs said:


> Did the patient previously have a supracervical hysterectomy and now the doc is taking out the cervix later?  Or is this just removal of the cervix but the uterus is left in place?
> 
> When you look at the operative report, is any part of the procedure accomplished vaginally?  Depending on the documentation, you could bill the Lap BSO 58661 and then use 57530 with a 59 modifer (unless it is just the cervical stump then use 57550), otherwise you will have to bill an unlisted laparoscopy code.



Yes, pt. had a Supracervical hyst "only" 2006. The tubes and ovaries remained for hormonal reasons.  The recent surgery that was performed was all done "laparoscopically" nothing from the vagina.  Which unlisted laparoscopic code do you suggest?    58578? that is for uterus but there is NOT  Cervix removal for Laparoscopic...Help!


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## ajs (Dec 16, 2011)

lisabooboo said:


> Yes, pt. had a Supracervical hyst "only" 2006. The tubes and ovaries remained for hormonal reasons.  The recent surgery that was performed was all done "laparoscopically" nothing from the vagina.  Which unlisted laparoscopic code do you suggest?    58578? that is for uterus but there is NOT  Cervix removal for Laparoscopic...Help!



I would not worry about a second laparoscopy code, you will be coding the lap BSO and the removal of the cervical stump is secondary so you can use the 57550-59, even though the approach is usually vaginal.  There is not an unlisted lap code and you are already billing another lap.  This is one of those cases where you bill the closest procedure you have.


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## Lbooth110 (Dec 30, 2011)

Thank you for your advise. This really makes sense.  I have been struggling with using the unlisted uterus code but I agree that 57550-59 will work in this case because that is what the out come is but not exactly what she had performed but very close.   What would you suggest if our physician "only" performed a Lap Trachelectomy?  Because she has and I billed out the unlisted Lap for uterus.  What would you use?
thank you 
Lisa


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