Ob-Gyn Coding Alert

Ob/gyn practices will find no surprises or serious reimbursement implications among the edits in Correct Coding Initiative version 8.0 (CCI 8.0), in effect Jan. 1-March 31, 2002. The changes pertinent to ob-gyn coding are listed as "nonmutually exclusive" codes (i.e., the procedure that the component code describes is considered part of the comprehensive code procedure). The CCI "Standard Policy Statement" indicates that these codes are bundled due to "CPT/HCPCS procedure code definition,"  meaning that the component code is already defined as part of the comprehensive code.

Bundled Combinations

1. Code 58953 now includes 49255, 58700, 58720 and 58940.

 

58953 bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking

49255 omentectomy, epiploectomy, resection of omentum (separate procedure)

58700 salpingectomy, complete or partial, unilateral or bilateral (separate procedure)

58720 salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)

58940 oophorectomy, partial or total, unilateral or bilateral.

2. Code 58954 now includes 38562, 38571, 38572, 49255, 58700, 58720 and 58940.

58954 bilateral salpingo-oophorectomy with omentectomy, total abdominal
 hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy

38562 limited lymphadenectomy for staging (separate procedure); pelvic and para-aortic

38571 laparoscopy, surgical; with bilateral total pelvic lymphadenectomy

38572   ... with bilateral total pelvic lymphadenectomy and peri-aortic lymph node sampling (biopsy), single or multiple.
 
3. Code 59001 now includes 76946.
     

59001 amniocentesis; therapeutic amniotic fluid reduction (includes
 ultrasound guidance)

 

76946 ultrasonic guidance for amniocentesis, imaging supervision
and interpretation.

CCI guidelines indicate that any of the component codes listed above may be billed separately from the comprehensive code with an anatomic modifier (such as modifier -RT [right side] or modifier -LT [left side]) or modifier -59 (distinct procedural service) appended to the appropriate code if the criteria for using these modifiers have been met. The wording of each comprehensive code suggests, however, that instances like these are rare.