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Re: Coding question From: Larry Glazerman (l.glazerman@rcn.com) Wed Nov 1 15:38:42 2000 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: K Dew: "Re: Coding question attn Brick Bills" Previous message: Brickster0@aol.com: "Re: Coding question" In reply to: K Dew: "Coding question" Next in thread: K Dew: "Re: Coding questionATTN Larry Glazerman" Reply: K Dew: "Re: Coding questionATTN Larry Glazerman" Reply: Paul Prior MD: "Re: Coding question" Kevin: I'm not sure the myomectomy code will fly, since it really isn't a distinct procedure. IMO, it was just done as part of, and to facilitate, the hysterectomy. A distinct procedure would be if, for example, you would have done a bowel resection, a cholecystectomy, or the like. Hopefully, the -22 modifier, in conjunction with a well-dictated op report, documenting the amount of extra time this case took and the difficulty in performing the procedure, should work. At 03:28 PM 11/1/00 -0600, you wrote: >If any of you listers would be so kind as to help here. > >Last week I did a TAH-BSO on a 42 year old G4P4 with an 18 week uterus >(after Lupron no less!) > >She is 4'9", 200 pounds. I had to really struggle with this case and ended >up needing to do a myomectomy before I could even approach the round >ligaments. Making a long story short I needed to take this uterus out >piecemeal, and to my horror, I needed to leave the cervix in because I >simply could not reach even with the long instruments. (this lady, at >appropriate weight, would be about a size 1, really narrow pelvis) > >I feel that the complexity of the surgery necessitates more than the simple >coding for TAH-BSO but not sure how to do it > >we have 58180 (sub-total hyst) and -22 modifier requesting 40% above usual >fee for the hyst and plan to use also 58140 with -59 modifier for the >myomectomy as it was a distinct procedure due to unusual circumstances. > >any comments (including flames) appreciated > >Kevin Dew, MD >OB/GYN >Bardstown, KY Next message: K Dew: "Re: Coding question attn Brick Bills" Previous message: Brickster0@aol.com: "Re: Coding question" In reply to: K Dew: "Coding question" Next in thread: K Dew: "Re: Coding questionATTN Larry Glazerman" Reply: K Dew: "Re: Coding questionATTN Larry Glazerman" Reply: Paul Prior MD: "Re: Coding question"

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