Ob-Gyn Coding Alert

Question: My ob-gyn documented the following procedure: Intraperitoneal placement was confirmed with the laparoscope; immediately extensive omental adhesions were noted blocking view of the lower abdomen and pelvic area. There was like a blanket of omental adhesions to the anterior peritoneum as well as the side walls. Kleppinger & scissors were used to take down adhesions in the infraumbilical areas so that the 10 mm scope could be inserted for viewing. This tedious dissection was taken to ensure hemostasis. No bowel adhesions nor active endometriosis. The lower abdominal/ pelvic adhesions were taken down using Kleppinger & scissors.Seprafilm which had been liquified was injected into the abdomen in the lower pelvic area hoping to prevent reformation of extensive adhesions.

I submitted this claim with 49329, but I received a denial stating this code doesn't match the op note. What should I report instead?

Kentucky Subscriber

Answer: You should report the laparoscopic lysis of adhesions (other than bowel adhesions) using 58660 (Laparoscopy, surgical; with lysis of adhesions [salpingolysis, ovariolysis] [separate procedure]). Because you have this specific code, you should not submit unlisted code 49329 (Unlisted laparoscopy procedure, abdomen, peritoneum and omentum).