# C-Section w/bilateral cystectomies



## house (Nov 7, 2008)

The patient had a c-section and the doctor removed a dermoid from the left ovary.  Should I could code 58925,51 along with the 59510?  Thanks for any help!


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## lavanyamohan (Nov 8, 2008)

Hello,
59510 covers all that.


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## FTessaBartels (Nov 10, 2008)

*59510 and 58925-51*



lavanyamohan said:


> Hello,
> 59510 covers all that.



Lavanya ... I don't see how the cystectomy is part of "routine" obstetric care. The codes are NOT bundled per CCI edits. 

House  ... I think you are right. Use the -51 modifier on the cystectomy code. 

F Tessa Bartels, CPC, CPC-E/M


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## lavanyamohan (Nov 11, 2008)

FTessaBartels said:


> Lavanya ... I don't see how the cystectomy is part of "routine" obstetric care. The codes are NOT bundled per CCI edits.
> 
> House  ... I think you are right. Use the -51 modifier on the cystectomy code.
> 
> F Tessa Bartels, CPC, CPC-E/M



Hello, 
The primary procedure is C-section and the cystectomy only followed, I suppose- also, a separate surgical incision was not made, I suppose. 
So I still think the primary procedure is only payable, from Medicare guidelines.
But, I do not know so much about the policies of several commercial payers - Kindly, verify your insurance payers about this.


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## lavanyamohan (Nov 13, 2008)

hello, 
to be more clear-the postoperative care covers the cystectomy,I feel. Kindly check.


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## lavanyamohan (Nov 14, 2008)

Hello,
May be in future if there are some more CPTs to distinguish between anterior duct and posterior duct , the anterior duct procedure can be billed in addition to any obgyn related care. We need CPTs.

Are there Cpts for cervical cerclage re repairs?
May be you have to suture it for three times with some patients-

Also, while doing papsmears, nabothian cysts outburst-requires additional cleaning up by the physician- no code to report in such instances. The speculum itself damges a little, they say and do not cover these valuble services.

When there are multiple knots and additional entaglements in the cord, additional time and labor with Cesarean operation- But usual reimbursement only.

Several Obgyn reports are pending like this.

non-obgyn-

Even with foot related procedures, gangrene excisions take up more time and cost - paid less- 

In some patients, abdominoplasty and inguinal hernia repair done on the same day, for two different excisions, different causes altogether, say, like hernia and peritoneal _lymph node _excision - only inguinal hernia procedure gets the payment; A vaginocele and a hysterectomy performed in the same DOS- only hysterectomy covered-

*Tenoplasty*, knee; often code confusion-
Alaska home bound people suffered knee jerks, often- Arthroplasty may not be considered for them, as only beginning of cartilage wearing off; 

For, some payers may consider a little more beneficial than the other, but no full reimbursement for the complete service provided- 
We need some more CPTs.

Kindly, pardon me if I had opened out more than I should as a coder.

Thank You.


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