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Ruptured Ectopic

David Posted Fri 04th of December, 2015 14:43:16 PM

My provider was called to the Emergency Room to evaluate a pt. The decision was made to take her to the Operating room. Pt. presented with Acute severe abdominal pain, left ovarian mass/cyst, hemoperitoneum, and ruptured right ectopic pregnancy. Surgery performed is Exploratory laparotomy, evacuation of 3 liter hemoperitoneum, Right salpingectomy with excision of ruptured ectopic pregnancy, laparoscopic left ovarian cystectomy and a D and C.
Can you help with coding to maximum level for me?

SuperCoder Answered Mon 07th of December, 2015 08:03:25 AM

Thanks for your query,

If the doctor performs exploratory laparotomy with right salpingectmy with excision of ruputured ectopic pregnancy, then laparotomy is included in salpingectomy procedure. In such a case, CPT 49000 can't be billed with cpt 59120. So, we can code only 59120-RT. But, if the exploration took an extensive time of the entire procedure, then we can bill 59120-RT with modifier 22. We cannot code evacuation of hemoperitoneum addionally because it is included in any abdominal surgical procedure. CPT 58662-LT for laparoscopic left ovarian cystectomy. CPT 58120 for D&C

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