Ob-Gyn Coding Alert
Count Hemostasis as Part of Procedure
Question: Patient is one day post-op for 58548 (Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling [biopsy], with removal of tube[s] and ovary[s], if performed). Then the ob-gyn went back in for an intraperitoneal hematoma. He performed a laparoscopic evacuation of hematoma and exploration for bleeding vessels, with coagulation and vascular clips applied. I am billing 49322 for the hematoma and 49329 for cautery and clips. Are there more applicable CPT® codes for this? Texas Subscriber Answer: You should only be billing 49322 (Laparoscopy, surgical; with aspiration of cavity or cyst [eg, ovarian cyst] [single or multiple]). You should not report a code for the hemostasis, because it is now part of the procedure. And don’t forget the modifier 78 (Unplanned Return to the Operating/Procedure Room by the Same Physician or Other Qualified Health Care Professional Following Initial Procedure for a Related Procedure During the Postoperative Period).
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