# 58661 vs 58662



## tracylc10 (Mar 13, 2018)

I am being told, *very adamantly*, that a laparoscopic cystectomy is coded with a 58661 by our head MD.  He states that the cyst is actually part of the adnexa.

I completely disagree with this, but am being told that I am wrong.  He went on to say that a cystectomy is by far more involved than a BSO.

He mentioned that a 58662-80 will not pay...  and that he and the other docs have agreed that the laparoscopic cystectomy will be coded with a 58661.

I feel like this is upcoding to get the assist paid. (fraud) 

Any thoughts on this?  And what should I do?  I'm afraid I could lose my job over this.



Addendum:
In looking at this further, the 58662 has a higher RVU.  So would this be down coding?


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## Beachbum32459 (Mar 13, 2018)

According to the 2018 OB/GYN coding companion CPT code 58661 is the laparoscopic removal of ADNEXAL STRUCTURES ie: ovary and or fallopian tubes (partial or total).  A Cystectomy is coded to 58662 "...excision of lesions of the ovary..." Now the question is did he just remove the cyst or did he also remove part of the ovary with the cyst?  Also cpt code 58662 does allow the use of modifier 80 for assisted surgeon.  Check payor requirements if it is a PA rather than an MD who assisted as they may require modifier AS instead.  

Hope you find this somewhat helpful.


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## tracylc10 (Mar 13, 2018)

Beachbum32459 said:


> According to the 2018 OB/GYN coding companion CPT code 58661 is the laparoscopic removal of ADNEXAL STRUCTURES ie: ovary and or fallopian tubes (partial or total).  A Cystectomy is coded to 58662 "...excision of lesions of the ovary..." Now the question is did he just remove the cyst or did he also remove part of the ovary with the cyst?  Also cpt code 58662 does allow the use of modifier 80 for assisted surgeon.  Check payor requirements if it is a PA rather than an MD who assisted as they may require modifier AS instead.
> 
> Hope you find this somewhat helpful.




Thank you very much, very helpful.  I don't know that he will hear me if I approach him with this, but I will talk to my manager about it.  

They only removed the cyst walls.  It's kind of weird, because the dictation states that the tubes and ovaries were taken, but the path report states that it was only fragments of a cyst wall....

I believe that the assistant was a CFA, Certified First Assistant.   Would that still fall under the AS modifier? 

Tracy


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