Ob-Gyn Coding Alert

Question: In the past month, we have had two cases of laparoscopic IUD removal due to the IUD perforating the uterine wall. The ob-gyn could not remove it vaginally. Incidentally, though, the ob-gyn performed both removals in conjunction with 58671. My surgeons want to bill an additional charge for the laparoscopic removal of the IUD (for which we would have to use an unlisted procedure), but my coding staff feel that adding modifier 22 to 58671 is more appropriate. Who is right?

Florida Subscriber

Answer: Either way conveys the same message (and delays payment of the claim). The unlisted code you would use is 49329 (Unlisted laparoscopy procedure,abdomen, peritoneum and omentum). Coding experts, however, prefer 58671-22 (Laparoscopy, surgical; with occlusion of oviducts by device [e.g., band, clip, or Falope ring]; Increased procedural services).

--  The answers for Reader Questions and You Be the Coder provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.