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Elizabeth Posted 8 Year(s) ago

58260 & 58290 are codes for vaginal hysterectomy`s depending on uterine weight, however my doctor does volume reduction with alot of these to avoid having to open patient ect., patients recover better and they are not kept in the hospital as long. There must be a way to code this and get better reimbursement.
He does not use the laparoscope for these procedures. CCI edits do not allow vag.myomecty w/vaginal hysterectomy.

Elizabeth Posted 8 Year(s) ago

58260 and/or 58290

Elizabeth Posted 8 Year(s) ago

58260, 58290,58145

SuperCoder Posted 8 Year(s) ago

Do you mean to say the physician has performed a panniculectomy/abdominoplasty/liposuction. So these codes can be found in a different section of CPT book i.e. dermatology. So as per the OP report, code from these section 15830-15839, 15847. But, if not then please provide me with some more details regarding this volume reduction procedure.

Elizabeth Posted 8 Year(s) ago

I will just type to you the part of the op-note that I believe goes over it. Incision was made along the cervicovaginal junction. The anterior and posterior cul-de-sac were entered without difficulty after some bites were taken incorporating the uterosacral ligaments and cardinal ligaments. There were adhesions anteriorly,dense adhesions where the c-section scars were,but dissection below these areas were sufficient.The uterine vessels were bilaterally clamped,cut, and doubly ligated with 0 Vicryl suture, incorporated in the anterior and posterior leaves of the broad ligaments. Two more bites were taken. Uterus was fairly bulky,did not flip very well. The cervix was amputated to make it allow easier approach to the left ovarian, uterine ligament,round ligament and tube,which was doubly clamped, cut, and doubly ligated with Vicryl suture in heaney fashion. In this fashion the right was done similarly.

That is what I have in op-note and basically the patient has/had a known leiomyomatous uterus, it was slightly enlarged and irregular shaped. So the way I understand it is like doing a myomectomy along with vaginal hysterectomy but those codes together do not pass CCI edits. The problem I have with that is that it is more work for him. Of course he could change it to abdominal hysterectomy, but thinks of patient. So I am thinking the only thing would either be unlisted code or modifier 22. It is the point that he is doing more than just a vaginal hysterectomy. Sorry this is so lengthy. Appreciate your feed back

SuperCoder Posted 8 Year(s) ago

As per the Op report the physician is performing an vaginal hysterectomy along with the removal of tubes and/or ovary. So as per the uterus weight you should either code 58262/58291. Myomectomy is not performed in this case. When a uterus is removed then why should a myemectomy be coded seperatley due to that reason the CCI edit is not allowing the edits between these codes.

Posted by Elizabeth, 8 Year(s). There are 6 posts. The latest reply is from SuperCoder.

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