HYSTERECTOMY CODING, PART 1 ~ 3 Steps Let You Take Charge of Your Hysterectomy Codes
Published on Fri Apr 27, 2007
Learn why knowing the weight of the uterus is so important Don't just correct your hysterectomy claims -- perfect them by narrowing down your possible coding choices. By following these three steps, you-ll find the right hysterectomy code every time.
Key: According to Donna C. Kroening, CPC-OGS, reimbursement manager for the department of obstetrics and gynecology at the Medical College of Wisconsin, when you code hysterectomies, you-ll have to review these factors in this order:
- approach
- size/weight
- extent of uterus removed
- additional procedures performed. Step 1: Analyze Your Ob-gyn's Approach The first thing you must do is decide what approach your ob-gyn used. This will help you narrow down the code series you-ll work with.
Open procedures: For a hysterectomy performed via the abdominal approach, you should look to 58150-58240. If your ob-gyn performed a hysterectomy using a vaginal approach, you-ll pull a code from the 58260-58294 series.
Laparoscopic procedure: For a laparoscopic-assisted vaginal hysterectomy (LAVH), you-ll use 58550-58554. If your ob-gyn performed a supracervical laparoscopic hysterectomy, you-ll report one of four new-for-2007 codes: 58541-58544.
Why this is so important: -There's a big difference between laparoscopic hysterectomies and ones performed through a laparotomy incision -- hence, higher relative value units (RVUs) and expected reimbursement- for the open procedures, says Debbie Sixkiller, surgery coordinator for Dr. C. W. Randolph in Jacksonville Beach, Fla.
Step 2: Seek Out the Uterus- Size Next, you need to know the weight of the uterus -- specifically whether it was 250 grams or less or more than 250 grams. This will narrow your coding options.
If the uterus weighed 250 grams or less, you-ll use 58260-58270 for vaginal approach procedures. You-ll use 58550-58552 if your ob-gyn used a laparoscopic approach or 58541-58542 if she performed a supracervical laparoscopic hysterectomy.
On the other hand, if the uterus weighed more than 250 grams, you-ll use 58290-58294 for vaginal approach procedures. You-ll use 58553-58554 if the procedure was laparoscopic or 58543-58544 if the procedure was a supracervical laparoscopic hysterectomy.
Why this is so important: -Without knowing the weight of the uterus, you could be leaving money on the table,- Kroening says. -Be certain that your pathology report includes that. We-ve worked hard with our pathology department to make certain the weight is always there.- Step 3: Evaluate the Hysterectomy's Extent An open or laparoscopic hysterectomy may have included more than simply removing the uterus.
The hysterectomy may be total, but you may also see a [...]