Ob-Gyn Coding Alert
Keep Track of Your Ob-Gyn's Approach
Question: My ob-gyn's op note says that he used a Veress needle to create a pneumoperitoneum and then he lasered and aspirated the same ovarian cyst. After that, he placed Falope rings. Can I bill for the aspiration and laser procedure on the cyst? I was thinking of 58662 and 58805-51.
South Carolina Subscriber
Answer: You should report 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method) and 58671-51 (Laparoscopy, surgical; with occlusion of oviducts by device [e.g., band, clip, or Falope ring]; multiple procedures) because the procedure description indicates the ob-gyn performed them through the laparoscope.
Caution: You are not going to get paid for both draining and lasering the cyst, so you should not also report 58805-51 (Drainage of ovarian cyst[s], unilateral or bilateral [separate procedure]; abdominal approach; multiple procedures). In addition, this code is an open procedure code, not laparoscopic (the laparoscopic would be 49322, Laparoscopy, surgical; with aspiration of cavity or cyst [e.g., ovarian cyst] [single or multiple]). If you look at your relative value units, you-ll find that 58662 has a higher value than 49322 in any case.
Ob-Gyn Coding Alert
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