Ob-Gyn Coding Alert

Question: I am looking for some CPT® codes for this scenario. I am attempting to do a preauthorization at this point, so I have no surgery note to refer to.

The patient has had endometriosis implants noted on prior surgeries and complains of chronic pelvic pain unresolved with conservative therapy. She will undergo LAVH (58550 or 58552 -- not sure if they will take ovaries yet, as this depends on endometriosis).

However, the provider notes that there is possible ablation of endometriosis in addition to the LAVH.  What code should we use for this? I am only assuming that the ablation would be done on adjacent structures, of course, since he is removing the uterus.

Is there any way to attempt to preauthorize this ablation procedure?

South Dakota Subscriber

Answer: You should use 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method). However, because he will be doing the ablation and some of the hysterectomy via the laparoscope, getting it paid is another matter. That will depend on where the implants are located.