Ob-Gyn Coding Alert

Reader Question:

You'll Likely Appeal Laparotomy Sterilization

Question: How should I report a tubal sterilization via laparotomy? The patient cannot have the laparoscopic procedure because she has massive adhesions. Kentucky Subscriber Answer: Generally, you will report this procedure with 58600 (Ligation or transection of fallopian tube[s], abdominal or vaginal approach, unilateral or bilateral) or 58615 (Occlusion of fallopian tube[s] by device [e.g., band, clip, Falope ring] vaginal or suprapubic approach). And, if the adhesions are indeed massive and documented in the patient record, you can submit 58740 (Lysis of adhesions [salpingolysis, ovariolysis]) in addition to the tubal. Keep in mind that some payers consider 58615 a 23-hour code, meaning they will reimburse for an inpatient stay of only 23 hours. Consequently, you may have to appeal this claim and include the ob-gyn's documentation to ensure proper payment.
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