Mary Beth Posted Thu 19th of March, 2020 15:24:38 PM
Would the following case be coded with unlisted 58679 and 44970? ...trocar placed in left lower quadrant and suprapubic area. We immediately identified the right ovarian torsion. Detorsion was performed with 360 degree clockwise untwisting of the torsion and this restored normal anatomy. The normal appendix was grasped at the base and elevated, mesentery of appendix divided and removed via laparoscopic retrieval bag. I have found no code for the detorsion and I think the appendectomy would be incidental since it was normal and no indicated purpose for removal is mentioned.
SuperCoder Answered Fri 20th of March, 2020 03:49:50 AM
Thanks for your question.
There is no specific code for detorsion of ovary; therefore,use code 58679 to report laparoscopy procedures of the oviduct or ovary that do not have a specific code in the female genital system.
When reporting a procedure with an unlisted code, submit a cover letter explaining the reason for choosing the unlisted code instead of a defined, active code. Include one or more similar codes and compare your service to those codes to justify the claim amount you are billing. Also include the operative notes and/or other relevant documentation to strengthen the claim and to avoid a possible denial. Your payers will consider claims with unlisted procedure codes on a case–by–case basis, and they will determine payment based on the documentation you provide.
If the physician's documentation does not show that the appendix was abnormal in some way -- in other words, if there was no medical necessity for removing the appendix -- then the removal is incidental to the surgery, and you should not report the appendectomy separately.
Hope this helps.
Mary Beth Posted Fri 20th of March, 2020 08:40:21 AM
SuperCoder Answered Mon 23rd of March, 2020 01:10:15 AM
Thank you, happy to help.