Ob-Gyn Coding Alert

Question: My ob-gyn performed an uterosacral neurectomy and cautery of endometriosis on the right ovary. I know that the neurectomy is unlisted- procedure code (49329). Would it be correct to bill 58662 and not 49329?

Arkansas Subscriber

Answer: Code 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method) represents only the cautery portion of the procedure you described. You can choose to add modifier 22 (Increased procedural services) to 58662 to represent the laparoscopic uterosacral nerve ablation (LUNA), if your physician's documentation has to support the use of this modifier.

Alternatively, you can bill the LUNA portion separately using 49329 (Unlisted laparoscopy procedure, abdomen, peritoneum and omentum). The payer will want to see a description of the procedure and information supporting the medical need to perform it.