Wiki hysterectomy coding

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dmkubida

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Our new physician does alot of robotic surgeries. She attempted a DaVinci hysterectomy on a patient which took up most of her surgical time but had to switch to vaginal hysterectomy (< 250 gm with BSO). I am thinking since RVU's are less for 58552 vs 58571- to bill 58552 with 22 modifier??
Any suggestions
 
If your doc used the laproscope and took the uterus out vaginally then you would use 58552. 58571 would only be used if the uterus is removed through the laproscope. DaVinci does not warrant any additional payment.
 
I have read that it does not matter if the uterus is pulled out through the vagina to use 58570-58573. 58550-58554 the majority of the work is done vaginally with laparopscopic assistance and with 58570-58573 the majority of the work is done laparoscopically. I use 58570-58573 to code my DaVinci hysterectomies.
 
ACOG came out with clarification in response to a Coding Clinic article. Coding Clinic is based on inpatient coding. ACOG based their CPT clarification on AHA Coding Clinic but that is based on ICD-9 Procedural Coding. CPT Assistant has not clarified. Everyone I spoke to is basing the coding on whether or not the contents are removed through the vagina or the port to determine the code. ACOG states is matters where most of the work was done not whether or not the contents are removed through the vagina. Is anyone else not clear on the coding on this?
 
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