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Posted By mary peabody on 09-16-2019, 12:18:48 in Ob-Gyn
Coding Laparoscopy excision of endometriosis, bilateral uretolysis, cystoscopy, proctoscopy and tubal assessment. Can we code the bilateral uretolysis and cystoscopy with the 58662? The physician states the uretolysis was performed due to retroperitoneal fibrosis and should be reported. In the past, I was told to append modifier 22 with 58662 for lysis of adhesions or uretolysis. The physician states the uretolysis was performed due to retroperitoneal fibrosis.

Pre-Op Diagnosis: Stage III endometriosis, deeply infiltrative endometriosis, chronic pelvic pain
 
Post-Op Diagnosis: Stage III endometriosis, deeply infiltrative endometriosis, chronic pelvic pain
 
Procedure: Laparoscopy, excision of endometriosis, lysis of adhesions, left ovariolysis, bilateral ureterolysis, cystoscopy, protoscopy, rectal integrity test, left fallopian tubal assessment.
 
Comments (1)
Posted By Melanie Witt on 09-18-2019, 18:22:40
First of all 50715 is an open abdominal procedure, not a laparoscopic one and it is in fact bundled with 58662 which is considered the primary procedure. You can use a modifier -59 to bypass the edit, but it goes on 50715 and this procedure pays more than 58662 so you may end up with a strange reimbursement depending on how the payer sees it. HIs postop diagnosis then needs to include the retroperitoneal fibrosis and he must have indicated this in the body of the op note. He mentions fibrosis on the right ureter but not the left. Good luck with payment on this one.
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