# need help coding this please



## IreneK63 (Dec 12, 2013)

Lap btl-left paratubalmass w left tubal torsion, left distal salpingectomy w/removalof paratubal mass, right fallope ring


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## Aubrey (Dec 12, 2013)

This is a tough one because you have

1) removal of adnexal mass, 58662
2) removal of left tube, 58661
3) occlusion by device of right tube, 58671

and you have to decide whether to code all 3.  I would look at the documentation to see if removing the left tube took care of the mass, or if the mass required significant extra work in addition to removing the left tube.  My instinct would be to code:

1) 58662, mass removal, 625.8 for mass & 620.51 for torsion
2) 58671-51 for occlusion of right tube, V25.2 desire for sterilization

The 58662 for the mass removal has a higher RVU than 58661 for the left tube removal, and many insurance companies will not pay both codes stating bundling even though there are no CCI edits against bundling any of your 3 CPT code choices.  If removing the mass took significant extra work beyond removing the tube, you could code all 3 with modifier 51 on 58661 & 58671.  In this case, your coding would be
58662, 625.8
58661-51, 620.51
58671-51, V25.2
and you would know you have a good shot of appealing if insurance did not want to pay all 3 codes.


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