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Re: Coding questionFrom: Braun, R. Daniel (rbraun@iupui.edu)Thu Nov 2 04:16:16 2000
The myomectomy should be considered part of the hysterectomy. That is double diping. The "-22" modifier takes that into consideration. Also if you file anything with the "-22" modifyer, be sure to send a copy of the operative report along as justification. AND don't file it electronically. Dan R. Daniel Braun, MD FACOG Clinical Professor Department of Obstetrics and Gynecology Indiana U. School of Medicine Indianapolis, IN 46202 OBGYN.net International Representative for United States Certified AllExperts Expert Check out my bio/ratings page! http://www.allexperts.com/displayExpert.asp?Expert=1236 -----Original Message----- From: K Dew [mailto:kdew@bellsouth.net] Sent: Wednesday, November 01, 2000 4:29 PM To: Multiple recipients of list OB-GYN-L Subject: Coding question 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
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