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Posted By Danielle Levy on 02-20-2019, 15:02:23 in Ob-Gyn
Melanie ,
Out physician performed a LSC bilateral salpingectomy and (L) oopherectomy as well. There were also adhesions to the sigmoid and omentum . Please see attached operative report . Would I only code 58661 and place a 22 modifier or Could I bill for the adhesions separately with modifier (59) . I thought I read somewhere that we can now place a (59) modifier to get additional payment only when the documentation and dictaiton indicates over and above additional work, however haven't seen any publications on that . Please advise how to code and if I am correct about modifier 59
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  1. OP REPORT.pdf
Comments (1)
Posted By Melanie Witt on 02-21-2019, 17:25:26
According to the most recent CCI file, both 44180 (laparoscopic lysis of bowel adhesions) and 58660 (laparoscopic lysis of adhesions to the adnexa) are bundled into 58661 and no modifier is allowed. Only if you have good documentation outlining the additional work should you add a modifier -22 to 58661. But usually the payer wants to know how much more work it really was and the op report does not mention how this surgery was harder in terms of time - something that should go in a letter to the payer when asking for more money using the -22. He also does not describe the adhesions very well- they could just as well have been filmy as thick and difficult to remove.
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