Oncology & Hematology Coding Alert

Question: The July issue of Oncology Coding Alert included a surgical example for an ovarian epithelial cancer patient. A more likely scenario for our gynecologic oncologist is to perform a bilateral salpingo-oophorectomy with omentectomy, hysterectomy, radical dissection for debulking, and pelvic and limited para-aortic lymphadenectomy. How should I code this example?


Wisconsin Subscriber

Answer: For the example you describe, report 58954 (Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking; with pelvic lymphadenectomy and limited para-aortic lymphadenectomy.)

If the gynecological oncologist performs an early-stage resection (instead of the typical debulking procedure) for the epithelial cancer patient, check your documentation to see if you should report 58951 (Resection of ovarian, tubal or primary peritoneal malignancy with bilateral salpingo-oophorectomy and omentectomy; with total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy).

If your gynecologic oncologist performs the procedure with another surgeon (for example, a gynecologist performs the hysterectomy), both surgeons should document the co-surgery and append modifier 62 (Two surgeons) to the appropriate CPT code.