Ob-Gyn Coding Alert

Question: My doctor did a TAH/BSO on a patient. The general surgeon did a colectomy and colostomy. They opened and closed. Therefore, my understanding is that I need to put modifier 52 on our procedure. The problem is, the doctor wants to add modifier 22 for difficulty, and it is well documented. What can I do? I can't put 52 and 22, right?


Texas Subscriber

Answer: If this is a Medicare patient, you can use both modifier 52 (Reduced services) and modifier 22 (Unusual procedural services), but private payers may disagree.

By using both modifiers, you are saying that the total abdominal hysterectomy, bilateral salpingo-oophorectomy (TAH/BSO) (58150, Total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]) was a reduced unusual procedure.

Best bet: When sending in this combination, make sure you send in the supporting documentation with the claim rather than waiting to be asked.