Laparoscopy, lysis of adhesions, Abdominal laparotomy with drainage of abscess, cholecystectomy with much difficulty, pelvic laparotomy, excision of mass anterior to uterus and between bladder and uterus.
Left salpingo-oophorectomy with a large cyst removal. Placement of drain.
Gyne exam under anesthesia with pap smear.
Need help coding this: I am looking at 47600-22, 58140, 58925 and Q0091. Or should I try and code the lysis with a 59 modifier??
There is an NCCI edit that exists with 58925 Ovarian cystectomy, unilateral or bilateral and 58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure).
Therefore; the two codes cannot be billed together. Determine the reason for the encounter; I am assuming the physician had planned the Cholecystectomy, which would need to be billed. I would bill for the Cholecystectomy, (The NCCI results were from FindACode.com, using the NCCI Validator. The edit is based on anatomic considerations with the following results.
NCCI Edit Results:
Edit exists with 58925. 58660 is a Column 2 code. If both 58925 and 58660 are submitted, only 58925 will be paid.
- This edit CANNOT be overridden via CCI-associated modifiers.
- Rationale: CPT "separate procedure" definition
The other codes look appropriate along with the 22 modifier for Increased Procedural Services as the physician notes the cholecystectomy was done with much difficulty.