Wiki 58571?

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hartford1

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Hello,
Could I get others opinion on the below operative note.
58571 was billed and we are getting a take back on this and saying the operative note does not support 58571.
Thank you so much,
Laurie


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Unless I am missing something, this looks to me EXACTLY like 58571. Perhaps their issue is with the 3rd paragraph "..specimen was removed vaginally." without stating the specimen was the uterus and cervix?? Another possibility is that the person who denied it was simply incorrect. Perhaps they mistakenly believe ovary removal is required (but it's ovaries and/OR fallopian tubes)?? Or they mistakenly believe if the specimen is removed vaginally that it's a LAVH (but it's not)?? I assume the op note is signed/electronically authenticated by the surgeon. I would certainly appeal this.
 
Okay great! That is what thought too but wanted to get other opinions. I appreciate your response. I will have this appealed.
 
Hi
Sometimes payers will reject a claim to save funds in their bank a while longer or just want to slow up the process by making you fix the denial.It deems you coded it correctly
Lady T
 
csperoni said:
Unless I am missing something, this looks to me EXACTLY like 58571. Perhaps their issue is with the 3rd paragraph "..specimen was removed vaginally." without stating the specimen was the uterus and cervix?? Another possibility is that the person who denied it was simply incorrect. Perhaps they mistakenly believe ovary removal is required (but it's ovaries and/OR fallopian tubes)??
Click to expand...
Also, The August 2021 CPT Assistant clarified: Total laparoscopic hysterectomy includes laparoscopically detaching the entire uterine cervix and body from the surrounding supporting structures and suturing the vaginal cuff. It includes laparoscopically bivalving, coring, or morcellating the excised tissues, as required. The uterus is removed through the vagina or abdomen. So you could also show the payer this excerpt as well. I agree that the description matches code 58571.
 
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