# incision of paratubal cysts during cesarean



## ljhaley@gmail.com (Jun 16, 2011)

hi there! While performing a cesarean my doc discovered and incised a left paratubal cyst. Excerpt from dictation: "The tubes were examined. A left paratubal cyst was identified, about 4x3cm, incised with clear fluid.  It was grasped using a hemostat and ruptured using Bovie and the cyst was drained."  I need to bill the 59510, with ICD-9 65101, V272, and was wondering the best way to add on the incision & drainage. Any ideas? Thanks!


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## preserene (Jun 16, 2011)

So long as the paratubal/ para ovarian cysts drainage do not have a distinct CPT code , can we merit it to the family of cysts of the uterine adenexa (which includes ovarian cysts , paratubal cysts or Gartners cyst). What holds good for ovarian cyst drainage could it be applied for the other cysts of uterine adenexa(HCC concept of adjustments)? just as it enjoys for the abscess pelvic and the tissues around ( 58823).

I would lean on for *58805-59.*  Separate procedure, not an integral part of cesarean, though, sequenced after the major procedural code.

I would like you to have a look into the code 58823,  which is for abscess is shared for all those abscesses in the area of pelvis, ovarian, paracolic etc, which basically includes paraovarian/para tubal abscess too.
Any other suggestion please?


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## ljhaley@gmail.com (Jun 20, 2011)

Thank you so much for the suggestions, especially the "why" behind your choices!  I'm going to review them with the doc again-she looked briefly at the 58823, and asked even though it is under "open" procedures, she noticed it said transvag/transrectal approach, which she questioned as it was open for the C sect...thanks!!!


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## preserene (Jun 20, 2011)

58823- I gave as an example only,  to correlate to how it is used as a common code for all the pelvic abscess. Just like that, this code 58805 can also be applicable to the paratublar /para ovarian/ or gartners duct cystomy, (which was done along with CS.
I am still for the 58805-59 after sequencing as the first one. major code.


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