Ob-Gyn Coding Alert

Question: The physician removed a hemorrhagic ovarian cyst during a total abdominal hysterectomy (TAH). Which modifier will bypass the CCI bundling edit for 58150 and 58925?

Maryland Subscriber

 
Answer: If this is a Medicare patient, the only way to bypass the edit is to use 58150 (total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]) and 58925 (ovarian cystectomy, unilateral or bilateral) with modifier -59 (distinct procedural service) appended. Other payers will probably accept modifier -51 (multiple procedures) on the second code, but it would not hurt to use modifier -59 as well because the definition of the TAH includes removal of the ovaries. Modifier -59 would explain why 58925 was distinct from the TAH.