Ob-Gyn Coding Alert

Answer: No. Billing for more than one laparo-scopic procedure is no different from billing for more than one abdominal procedure. The insurance company will discount any additional procedures through the approach route (and Medicare subtracts the fee allowance amount for a diagnostic laparoscopy from the total relative value units [RVUs] from each additional laparoscopic code listed on the claim to be sure that it pays for only one laparoscopic "approach").

The original question asked if a laparoscopic salpin-gostomy (58673), laparoscopic endometrial fulguration (58662), laparoscopic lysis of adhesions (58660) and chromotubation (58350*) could be billed together. The answer would be yes, depending on the preference of the payer. Normally you would list the most extensive procedure first, followed by the other procedures, each with a modifier -51 (Multiple procedures). In the case of the lysis, you might want to add modifier -59 (Distinct procedural service) instead because payers frequently bundle lysis when done at the same time as other procedures.