Ob-Gyn Coding Alert

Question: My ob-gyn performed an operative laparoscopy, right salpingo-oophorectomy, left ovarian biopsy, lysis of adhesions, and a left tubal ligation via electrocautery. How should I report this surgery? Kentucky Subscriber Answer: You should report 58661-RT (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]; Right side) for the laparoscopic right salpingo-oophorectomy. For the left tubal ligation, you'll report 58670-LT (Laparoscopy, surgical; with fulguration of oviducts [with or without transection]; Left side). Finally, for the ovarian biopsy, you would report 49321-51 (Laparoscopy, surgical; with biopsy [single or multiple]; Multiple procedures). Heads up: You do not need modifier LT on the biopsy code (49321-51) because the Correct Coding Initiative (CCI) does not bundle the biopsy into 58661 or 58670. You need to use modifiers LT and RT (Right side) only when you're bypassing an edit -- which is the case for 58670, which CCI bundles into 58661.