Wiki new to gyn

[bstegall]

So many procedures, not sure which are bundled.
Doctor did:
Total vaginal hysterectomy
Anterior and posterior repair
Vaginal vault suspension with sacrospinous ligament fixation
Anterior vaginal wall mesh interposition, uphold
Posterior vaginal wall Xenform graft interposition
Midurethral sling procedure, Solyx
Intraoperative cystoscope
help please

 

[Emmy1260]

Based on your limited info, here are some code suggestions. You will need modifiers for multiple procedures. I question whether the vault suspension is not part of the hysterectomy. I have not billed separately for it, though this may be a more complex procedure than what our surgeons have done.

There is some debate with 52000 cystoscopy with these procedures. I bill for it, though the insurance may not pay it.

So many procedures, not sure which are bundled.
Doctor did:
Total vaginal hysterectomy 58260-58294 depending on uterus weight, BSO, etc.
Anterior and posterior repair 57260
Vaginal vault suspension with sacrospinous ligament fixation57282
Anterior vaginal wall mesh interposition, uphold+57267
Posterior vaginal wall Xenform graft interposition+57267
Midurethral sling procedure, Solyx57285
Intraoperative cystoscope 52000
help please

According to Correct Code Check, "Code 57285 is a component of column 1 code 57260 but a modifier is allowed in order to differentiate between the services provided."

 

[bstegall]

thank you so much, that was very helpful

 

[brownnd28]

Help

I am new to OB Gyn I can use some help.

We are billing 76817 and 76805 billing on same day. What modifier should I be using? Caresource only paid for one and denying the 76805 as bundling.

thanks in advance

 

[Cmama12]

You don't need a modifier to bill both. They do not bundle. In the CPT book under 76817 it says " if transvaginal examination is done in addition to transabdominal examination, use 76817 in addition to appropriate transabdominal code. "
76805 is usually only payable once as a screening.