desireewhite185@yahoo.com
Networker
Hello,
My physician was adamant that the right ovarian cystectomy he performed at time of fulguration of endometriosis are two separate procedure and both billable. Far as I can tell this procedure would be billed under CPT 58662. Anyone else have another code they think would be billable? 58662 is bundled with 58660. This was done laparoscopically. Thank you! I posted some of the note below.
**Findings: She had a small anteverted uterus that sounded to 7.5 cm. She had multiple focuses of endometriosis throughout the posterior cul-de-sac and in both ovarian fossae. She also had multiple focuses of endometriosis on the bladder flap anterior to the uterus. Her right ovary had a hemorrhagic cyst that was not an endometrioma. This was bleeding into the pelvis.
**...prior to using the argon beam I did excise a small piece of peritoneum on the left side close to the uterosacral ligament. This was peritoneum that was overlying the uterosacral ligament. There were some blue-black lesions in this area. That specimen was handed off. I then used the argon beam to fulgurate the endometriosis. I did this broadly over large swabs of the posterior cul-de-sac, the left ovarian fossa, the right ovarian fossa, and the anterior peritoneum. Once this was done, I then continued to note the bleeding into the pelvis. I noted that that this was coming from the right ovary. There was a cystic structure there. I used the argon beam to enter the cyst and noted that more blood came out. I attempted to cauterize the base, but both with the argon and with electrocautery. However, there continued to be bleeding. I then began to bluntly dissect out the right ovarian cyst. Once I was able to grasp the cyst wall and pull it off of the ovary, I cauterized the base, again both with argon and electrocautery.
My physician was adamant that the right ovarian cystectomy he performed at time of fulguration of endometriosis are two separate procedure and both billable. Far as I can tell this procedure would be billed under CPT 58662. Anyone else have another code they think would be billable? 58662 is bundled with 58660. This was done laparoscopically. Thank you! I posted some of the note below.
**Findings: She had a small anteverted uterus that sounded to 7.5 cm. She had multiple focuses of endometriosis throughout the posterior cul-de-sac and in both ovarian fossae. She also had multiple focuses of endometriosis on the bladder flap anterior to the uterus. Her right ovary had a hemorrhagic cyst that was not an endometrioma. This was bleeding into the pelvis.
**...prior to using the argon beam I did excise a small piece of peritoneum on the left side close to the uterosacral ligament. This was peritoneum that was overlying the uterosacral ligament. There were some blue-black lesions in this area. That specimen was handed off. I then used the argon beam to fulgurate the endometriosis. I did this broadly over large swabs of the posterior cul-de-sac, the left ovarian fossa, the right ovarian fossa, and the anterior peritoneum. Once this was done, I then continued to note the bleeding into the pelvis. I noted that that this was coming from the right ovary. There was a cystic structure there. I used the argon beam to enter the cyst and noted that more blood came out. I attempted to cauterize the base, but both with the argon and with electrocautery. However, there continued to be bleeding. I then began to bluntly dissect out the right ovarian cyst. Once I was able to grasp the cyst wall and pull it off of the ovary, I cauterized the base, again both with argon and electrocautery.