Ob-Gyn Coding Alert

Question: My ob-gyn performed a right ovarian cystectomy and removed a bilateral salpingectomy. Can I report both 58661 and 49322-59?


Tennessee Subscriber

Answer: You should not report 49322 (Laparoscopy, surgical; with aspiration of cavity or cyst [e.g., ovarian cyst] [single or multiple]) because this code is for the aspiration of an ovarian cyst, not the removal of the cyst.

If the ob-gyn took part of the ovary in the process of removing the cyst, you should report 58661 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]). This code covers both procedures.

If the ob-gyn took only the cyst, you can bill 58661 and 58662 (...with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method).

The National Correct Coding Initiative does not bundle these two codes, so you don't need to include modifier 59 (Distinct procedural service). However, if the payer does recognize the anatomic modifiers, you can report 58662-RT (... right side) and 58661-51.

You don't need an anatomic modifier for 58661 because the ob-gyn removed the tubes from both sides.