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Posted By Mary Peabody on 11-15-2019, 19:38:30 in Ob-Gyn
Hello Melanie Witt

Are there any coding guidance on coding for Laparoscopy, excision of endometriosis, lysis of adhesions, bilateral ovariolysis, bilateral ureterolysis, bilateral ovarian cystectomies, cystoscopy, protoscopy, and rectal integrity test for stage four endometriosis?

Is there a Webinar that I can purchase that discussed endometriosis and coding?
Comments (3)
Posted By Mary Peabody on 11-19-2019, 19:27:29
Hi Melanie

CPT 58662 will be reported for both the excision of endometriosis and the bilateral cystectomy? Should a modifier 22 be reported when both procedures are performed? The provider excise endometriosis in many places and does the cystectomy, it seems like a lot of work for only one code.
Posted By Mary Peabody on 11-18-2019, 19:54:24
Thank you so much
Posted By Melanie Witt on 11-18-2019, 16:28:57
None that I know of. The lysis will almost always be bundled and you can always add a modifier -22 to 58662 for severe cases of endometriosis. The ureterolysis will generally be bundled unless you can show retroperitoneal fibrosis, but there is no code for laparoscopic ureterolysis so only an unlisted or adding a modifier -22 will get you anywhere. And of course you have to have good reasons for the cystoscopy (which is more and more being bundled, especially if done to make sure the ureters were not compromised during the extensive surgery) . As to proctoscopy (which is coded using the protosigmoidoscopy codes), that may be reported separately but again, the reason for it must be stipulated. If you are referring to the use of Betadine to test for rectal integrity after removal of endometriosis, you probably are out of luck as that would be categorized as the surgeon checking his work.
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