Ob-Gyn Coding Alert

Question: My physician performed a laparoscopic radical parametrectomy, upper vaginectomy, and a bilateral pelvic lymphadenectomy. Patient has cervical cancer that another provider found at the time of a prior vaginal hysterectomy. What CPT code(s) should I report?

Answer: The best option would be to report 49329 (Unlisted laparoscopy procedure, abdomen, peritoneum and omentum) for the parametrectomy/vaginectomy and compare the work to 57107 (Vaginectomy, partial removal of vaginal wall; with removal of paravaginal tissue [radical vaginectomy]). For the bilateral lymphadenectomy, you can report 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy).