Ob-Gyn Coding Alert

Question:My ob-gyn has a patient scheduled for a total abdominal hysterectomy and bilateral salpingo-oophorectomy. Another physician performed a bilateral periaortic and partial pelvic (common iliac nodes) lymphadenectomy, because the patient had endometrial adenocarcinoma. My ob-gyn removed both tubes and ovaries but did not perform the planed hysterectomy due to some concerns with the local extension of the tumor the patient had. Here's what the note stated:Preoperative Dx- endometrial adenocarcinoma well differentiatedNeed For Surgical StagingPost Op Dx-Endometrial Adenocarcinoma well differentiatedProbable locally advanced endometrial adenocarcinoma with invasion of right pelvic sidewallinability to perform hysterectomyWhat should I report for my physician's portion? Connecticut SubscriberAnswer: Because this was an initial surgery for endometrial -- and not ovarian -- cancer you can only bill each part of the surgery separately. This means that your ob-gyn bills 58720 (Salpingo-oophorectomy, complete or partial, unilateral or bilateral [separate procedure]). This code qualifies the service that he performed. Remember, you [...]