Ob-Gyn Coding Alert

Question: How should I code a laparoscopic uterine suspension? Can I use 49320 and 58400 instead of unlisted procedure code 58578? Wyoming Subscriber Answer: You should bill only 58578 (Unlisted laparoscopy procedure, uterus). You cannot report 58400 (Uterine suspension, with or without shortening of round ligaments, with or without shortening of sacrouterine ligaments; [separate procedure]) because it represents either an open or vaginal approach procedure. CPT rules disallow reporting an open or other method procedure for a surgery that the physician performed laparoscopically -- even if that code seems perfect in every other way. Also, because the procedure you are performing includes diagnostic laparoscopy, you should not report 49320 (Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]). Beware: Avoid 57425 (Laparoscopy, surgical, colpopexy [suspension of vaginal apex]). This procedure is not the same thing as a uterine suspension. Physicians are starting to do this procedure (laparoscopically, not abdominally) again, so you might be seeing a new code for it in the future. -- The answers for Reader Questions and You Be the Coder provided by Melanie Witt, RN, CPC-OBGYN, MA, an ob-gyn coding expert based in Guadalupita, N.M.