Ob-Gyn Coding Alert

Question: My ob-gyn assisted on a total abdominal hysterectomy bilateral salpingo-oophorectomy (TAH/BSO) for another surgeon. Then, he performed an appendectomy as the primary surgeon on the same with patient (with other surgeon as the assist). How should I bill this so that each surgeon is paid appropriately?

New York Subscriber

Answer: Assuming you have a medical indication for removing the appendix (other than a ruptured appendix), your ob-gyn bills 44950-52 (Appendectomy; Reduced services) and 58150-80 (Total abdominal hysterectomy [corpus and cervix],with or without removal of tube[s], with or without removal of ovary[s]; Assistant surgeon). You would need modifier 52 because the ob-gyn did not open or close the abdominal procedure.

The other doctor will bill 58150, 44950-80.　The other doctor does not report modifier 52 with 49950, because he did open and close.

Watch out: You should not report +44955 (Appendectomy; when done for indicated purpose at time of other major procedure [not as separate procedure] [List separately in addition to code for primary procedure]), because it is an add-on code only for the surgeon who does both the primary surgery and the appendectomy. Refer to CPT Assistant, September 1996.

-- The answers for Reader Questions provided by Melanie Witt, RN, CPC,COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.