Ob-Gyn Coding Alert

Question: Why does 58551 have a lower relative value than 58550?

Kathy Howard
Womens Care Center, Lexington, Ky.

Answer: Code 58551 (laparoscopy, surgical; with removal of leiomyomata [single or multiple]) has a lower relative value than 58550 (laparoscopy, surgical; with vaginal hysterectomy with or without removal of tube[s], with or without removal of ovary[s] [laparoscopic assisted vaginal hysterectomy]) due to the practice expense portion of the resource-based relative value system (RBRVS).

The Medicare RBRVS fee schedule assigns a resource-based relative value to the three components of pricing a service: a physician work relative value, a practice expense relative value and a malpractice expense relative value. Although the physician work and malpractice expense relative values are resource-based, the practice expense component of each service is in transition from a charge-based practice expense relative value unit (RVU) to a resource-based practice expense RVU. This transition, which will be implemented over four years, started with the practice expense values effective Jan. 1, 1999. Currently, the total relative value is 23.59 for 58550 and 21.12 for 58551. Effective Jan. 1, 2002, this discrepancy will correct itself. At that time the total RVU for 58550 will be 21.68 and 21.70 for 58551.