Ob-Gyn Coding Alert

Question: I understand that I should use 58578 for a laparoscopic supra-cervical hysterectomy, but I'm not sure how to report the procedure with removal of tubes and ovaries. Should I still report 58578 with modifier -22 and send a report? Or should I also bill 58679 with modifier -51? New Hampshire Subscriber Answer: For the laparoscopic supracervical hysterectomy with salpingo-oophorectomy, you should not report 58578-22 (Unlisted laparoscopy procedure, uterus; unusual procedural services) or 58679-51 (Unlisted laparoscopy procedure, oviduct, ovary; multiple procedures). You should instead report only 58578 with no modifier attached. When you use an unlisted-procedure code, you should not add a modifier of any kind because it is "by special report," according to CPT. This means that the unlisted-procedure code will have the total description you give it, and you will decide what your fee should be when your physician performs the procedure. The next time you report the unlisted-procedure code, it might be for a completely different procedure with a different fee attached to it. -- The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.; and Peggy A. Stilley, CPC, office manager for Women's Healthcare Specialists, an Oklahoma University-based private ob-gyn practice in Tulsa.