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Ob-Gyn Coding Alert

Reader Questions:

Unnecessary Modifier 52 Use Could Cost You

Published on Tue Apr 26, 2011

Question: My ob-gyn saw a patient with ovarian cancer. He performed a total abdominal hysterectomy (TAH), bilateral salpingo-oophorectomy (BSO), omentectomy, left pelvic lymph node dissection, and limited para-aortic lymph node dissection. Because he removed all the pelvic lymph nodes on the left side but none on the right, should I use modifier 52? South Carolina SubscriberAnswer: No. You should not apply modifier 52 (Reduced services) to 58951 (Resection [initial] of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy). Notice that 58951's descriptor does not specify bilateral. Therefore, you should not apply modifier 52 if the ob-gyn only removed the pelvic lymph nodes from one side.
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