Does Weight or Number of Fibroids Matter When Coding a Myomectomy?
Question: A gynecologist performed an abdominal myomectomy removing a single intramural myoma weighing 260 g. Should I report 58146 because the fibroid weighs more than 250 g or do I report 58140 since it is only one myoma? Connecticut Subscriber Answer: Great question! You will assign 58146 (Myomectomy, excision of fibroid tumor(s) of uterus, 5 or more intramural myomas and/or intramural myomas with total weight greater than 250 g, abdominal approach) to report the abdominal myomectomy because the fibroid weighed more than 250 g. According to CPT® Assistant, Volume 13, Issue 6, code 58146 is used when the provider removes five or more intramural “or intramural myoma(s) with total weight greater than 250 grams.” This means that if the physician removed three myomas weighing 275 g, then you’d assign 58146. Intramural myomas take more effort to remove than subserosal or surface myomas. You’ll use 58140 (Myomectomy, excision of fibroid tumor(s) of uterus, 1 to 4 intramural myoma(s) with total weight of 250 g or less and/or removal of surface myomas; abdominal approach) regardless of the total weight of the surface myomas or how many surface myomas the physician removed via an abdominal approach. Mike Shaughnessy, BA, CPC, Production Editor, AAPC
