Ob-Gyn Coding Alert

Question: My ob-gyn performed a partially complete laparoscopic hysterectomy. Then, he converted to a completed abdominal procedure. How should I report this: one code with modifier 53 and 22 or just the abdominal code? Colorado Subscriber

Answer: Report the final abdominal procedure (such as 58150, Total abdominal hysterectomy [corpus and cervix], with or without removal of tube[s], with or without removal of ovary[s]), and add modifier 22 (Increased procedural service). You cannot bill modifier 53 (Discontinued procedure) unless the ob-gyn stops all surgery and sends her to recovery. This modifier is used when the ob-gyn performs the surgical prep and the patient is under anesthesia, but then due to a problem with the patient that threatens her well-being, the procedure is discontinued.