# Need advice on how to code LUNA



## tobeornottobeacoder (Jun 5, 2013)

I have a doctor that does the LUNA procedure quite a bit.   I have been doing some research on this and this is considered experimental and investigational.  There have been several sites suggesting using unlisted codes of 58999 or 58578.   There has also been suggestions on appending the primary procedure with modifer 22.   I am looking to see what everyone else is doing out there and if you have even come across trying to get reimbursement for this procedure.  Any suggestions would be very helpful.  This is the dicatation given on this procedure:

"We initially addressed the multiple implants of endometriosis.  This was done with a needle-tip Bovie for the larger implants, and the superficial implants on the ovaries were addressed with a ball-tip.  The right ovary in particular had "streaking" of reddish endometriosis on the ovary, along with several dark implants, and the same was true but to a lesser extent on the left ovary.  We then used the needle-tip to drain several of the ovarian cysts on each ovary, and clear yellowish fluid returned.  We then used the needle-tip on the implant on the inside of the left uterosacral ligament.  This was thoroughly cauterized, going deep enough to eliminate endometriosis.  We then did a uterosacral nerve ablation, starting at the point where there was endometriosis, directly on the ligament close to the insertion on the uterus.  We then used a ball-tip on the inside of the peritoneal defect in the cul-de-sac and the area on the right pelvic sidewall was elevated away from major vasculature.  The ureter was identified and felt to be well away from our area on intended cauterizaton, and we then used a needle-tip to totally vaporize this area."


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