Wiki Salpingectomy and LSO on same day

[Kathy Stone]

How would I code for a Laparoscopic salpingectomy(for sterilization) and a laparoscopic left oopherectomy done on the same day? Would I just bill the 58661 once with both diagnosis's? (The insurance will cover at 100% for salpingectomy for sterilization, but not if done for diagnostic reason(cyst). I wondered about adding a 22 modifier, but the 58661 is for (partial or total oophorectomy/and/or salpingectomy? I'm leaning towards just billing once with both diagnosis and attaching the operative note??? Any help would be greatly appreciated

 

[csperoni]

I would bill this 58661-50. Primary dx sterilization. 2nd dx reason for oophorectomy.
-50 is a valid modifier for 58661, but this is a code where Medicare and some commercial carriers have differing guidelines.

 

[nickelclaw]

no mod 50 on 58661 unless payer guidelines want it below is the CPT assistant on such:
yes bill once with the dx's

Fallopian tube and ovary laparoscopic removal, correct reporting
CPT Assistant, May 2010 Page: 10 Category:
Related Information
Surgery: Female Genital System
Question:
If a surgeon performs a laparoscopy with bilateral removal of ovaries and/or fallopian tubes, should code 58661, Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy), be reported with Modifier 50, Bilateral procedure,appended? Is the laparoscopy procedure described by code 58661 considered inherently bilateral?
Answer:

Code 58661 describes a bilateral procedure, which includes the excision and removal of tubes and/or ovaries, by any method. Therefore, if a laparoscopy and bilateral removal of ovaries and/or fallopian tubes are performed, it would not be appropriate or necessary to append Modifier 50 to indicate the procedure was performed bilaterally.(1) In addition, if the surgeon performs a laparoscopy with removal of an ovary and/or fallopian tube on one side, code 58661 would still be reported without modification. (2) Also, when this procedure is performed unilaterally, it is not necessary to report modifier 52, Reduced Services. The word "or" between "partial or total" within the descriptor of code 58661 indicates this already.

 

[csperoni]

58661 is one of those situations where CMS and AMA guidelines differ. -50 is a valid modifier for 58661. I use this code at least weekly if not daily. It does depend on the carrier, but most do pay additional.