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GYN: Coding conundrumFrom: Garry E. Siegel, M.D. (garrys@mindspring.com)Thu Feb 26 19:16:58 1998
While I do not wish to divulge the embarrassing details, today I attempted an LAVH-BSO, and after completing the lapscope part (IP ligaments, rounds, bladder peritoneum), I was unable to proceed vaginally because of a stenotic upper vagina and weird anatomy where I actually incised the vagina proximal to the cervix circumferentially. Thus, I went and did a TAH BSO and closed the vagina. How do you code this? (I don't have a CPT book, but I know the concepts, I think) 1. TAH BSO code with a -22 modifier for extra services? This is my first choice. 2. LAVH code with the modifier (is it -59? I'll look it up) that says you tried but couldn't do it, and then code a regular TAH BSO? 3. Should I code for the vaginal repair separately, or should this be part of the -22, if used. Personally, I favor choice 1 for all, sending an op note with the claim on paper. Garry
-- Garry E. Siegel, M.D., FACOG Private Practice Roswell, Ga.
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