Ob-Gyn Coding Alert

Question: How should I code laparoscopic left salpingo-oophorectomy (LSO) with ligation of an arterial pumper?
        
Ohio Subscriber  
Answer: The code for a laparoscopic partial LSO is the same as for a complete LSO: 58661. Whether you bill separately for the ligation of the arterial bleeder depends on the cause of the arterial bleeding. 
 
If an artery was bleeding as a result of a mishap during surgery, hemostasis (repair of the artery) is included in the procedure.
 
If there was bleeding prior, you can bill 37617 (Ligation, major artery [e.g., post-traumatic, rupture]; abdomen) or simply add modifier -22 (Unusual procedural services) to 58661.
  You Be the Coder and Reader Questions were answered by Tori Heckart, insurance specialist with Ottumwa Ob/Gyn in Ottumwa, Iowa; Patti Kidd, billing specialist for Beal and Costantino, P.C., in Tucson, Ariz.; Tammy Langley, insurance specialist for San Dimas Medical Group in Bakersfield, Calif.; Harry Stuber, MD, a gynecologist based in Cookeville, Tenn.; and Melanie Witt, RN, CPC, MA, an ob/gyn coding expert based in Fredericksburg, Va.