Wiki Laparoscopic Hysterectomy with B/L salpingo-oophorectomy, resection of mass small bowel, tumor reductive surgery

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The procedure was a Laparoscopic Hysterectomy with B/L salpingo-oophorectomy, resection of mass small bowel, tumor reductive surgery. I would code with 58575 but they did not perform a omentectomy? Can i still use 58575 with modifier 52? (coding for a facility) Or should we use 58571 & 58662.

residual tumor: 1-2 mm nodules on the peritoneal surface of the anterior abdominal wall and diaphragm. scaring along the colon wither it had been adherent to the mass

Thoughts?
 
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Hi, I am a new coder, still learning but since no body responded, I will dare to post my rational.
1. You can code 58575-52 if all is done except Omentectomy.
2. The report is missing more details on 'resection of mass small bowel". I would assume that a small bowel was not resected in any kind of form, only tumor which qualifies for 'debulking' :)
 
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I don't code facility ever, but from a profee coding perspective, I would code this as 58575 WITHOUT -52. In this scenario, I would consider omentectomy to be a minor part of the overall procedure and do not think it warrants -52.
Here is the rationale I am using based on SGO's 2021 coding Q&A top of page 6:
What code is best to use for an interval ovarian debulking surgery with TAH-BSO extensive pelvic dissection? There was no omentectomy or lymphadenectomy. Is it best to use 58150-22 (increased procedural services) or 58953? If I used 58953, would it be necessary to put a 52 reduced services modifier on it?
If there was described debulking of peritoneal implants, whether or not they turned out to be viable malignancy, use a debulking code- i.e., 58953. In the context of extensive debulking without omentectomy, it is reasonable to not reduce it with a 52. If there was just lysis of adhesions without debulking, then 58150-22 or 58956-52.

While the approach and codes are different in your example, I would use the same rationale of "In the context of extensive debulking without omentectomy, it is reasonable to not reduce it with a 52."
 
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Wow, what a Great Article from SGO! Thank you so much, dear Crhistine, for posting it for all of us! I spent hours reading, comprehending it and making notes for myself. There is so much to learn in OBGYN oncology procedures! We greatly appreciate your time and sharing knowledge with us. Thank you. (it's Sunday, I should take a well-deserved break now :) )
 
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