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Wiki 58146 & 58740

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klapetri@ilovemygyn.com

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OB/GYN -New York

GHI is requesting refund on CPT code 58740

Codes billed-
58558- N92.0 N85.2
58146 59- D25.0 D25.2 N85.2
58740- N73.6

Is there a modifier to bill on 58740 for it to be payable?

Or is this always bundled?
 
Yes, 58740 for lysis of adhesions is always bundled (column 2 code) with 58146 abdominal myomectomy. If there are extensive adhesions, requiring significant additional time/work, then -22 on 58146 may be appropriate.
I would note that it would be unusual (but certainly not impossible) to have both 58558 (hysteroscopy with/without D&C and polypectomy) and 58146 (abdominal myomectomy >5 myomas or wt > 250gm) performed at the same time. You may want to check the op note and coding.
 
Does it matter if two different sub-specialties are involved? My scenario is Gynecologist performed 58146 and called in Gyn-Oncologist to perform lysis of adhesions in order to complete the myomectomy. Looking at billing 58740 to the Gyn-Oncologist versus billing 58146-81.
 
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