Pamela Posted Fri 17th of November, 2017 14:48:50 PM
My oncologist wants to know if he can charge when he displaces the ovaries and protects them from radiation during surgery on a woman of child bearing age? I was leaning toward adding a 22 modifier to the surgery code as this is not usually done with the procedure. He is wondering about 58679,58825, or 58662 but is being denied when he uses any of these. Also, he wants RVUs for the time it takes to do that over and above the surgery. I am not sure what I should tell him.
SuperCoder Answered Mon 20th of November, 2017 02:43:31 AM
CPT 58679 is for Unlisted laparoscopy procedure, oviduct, ovary. This code is used when laparoscopy procedures of the oviduct or ovary that does not have a specific code in the female genital system. The procedure could involve a new technology or an uncommon one. Do not use this code if there is another code that describes the service using a laparoscopic approach.
CPT 58825 is for Transposition, ovary(s)- In this procedure, the provider places the ovaries behind the uterus and sutures them in place via an abdominal incision. This procedure protects the ovaries before the patient receives pelvic radiation to treat cancer. This procedure seems closest to your provided description, but not exactly performed as the code description says. So, cannot be coded.
CPT 58662 is for laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method. In this procedure, the provider destroys or excises lesions, tumors, or cysts found on the ovary, around the bladder, uterus, rectum, and or on the peritoneum. The provider performs this procedure with a laparoscope.
As per your description, it seems that oncologist displaced the ovaries just to protect from radiation during surgery on a woman of child bearing age, which is not payable separately. Use modifier 22 (Increased Procedural Services) with the surgery procedure performed to support physician’s extra work when performed the procedure is more than typically needed. Attach op-report with the claim to support the modifier 22.
For the modifier 22, there is not such RVU available, payers decide the payment amount.
For the mentioned procedures, below are the current RVUs:
58679- Total National RVU Facility=0.00 and Non-Facility=0.00 (not described for unlisted procedures)
58825- Total National RVU Facility=21.58 and Non-Facility=21.58
58662- Total National RVU Facility= 20.23 and Non-Facility= 20.23