Forum - Questions & Answers

Jun 2nd, 2015 - kharper 3 

Cesarean Delivery & Salpingectomy

We are having denials when billing these procedures together... Any thoughts?

Jun 2nd, 2015 -

re: Cesarean Delivery & Salpingectomy

can you give me the CPT® codes you are using please, thanks, I work in a OBGYN office and I will get the correct codes from our surgery coder:)

Jun 2nd, 2015 - kharper 3 

re: Cesarean Delivery & Salpingectomy

The MD's are giving us 59510 & 58700-51

Jun 2nd, 2015 - petunia 195 

re: Cesarean Delivery & Salpingectomy

That is why. 58700 is designated as a separate procedure.

If a CPT® code descriptor includes the term “separate procedure”, the CPT® code may not be reported separately with a related procedure. CMS interprets this designation to prohibit the separate reporting of a “separate procedure” when performed with another procedure in an anatomically related region often through the same skin incision, orifice, or surgical approach.

A CPT® code with the “separate procedure” designation may be reported with another procedure if it is performed at a separate patient encounter on the same date of service or at the same patient encounter in an anatomically unrelated area often through a separate skin incision, orifice, or surgical approach. Modifier 59 or a more specific modifier (e.g., anatomic modifier) may be appended to the “separate procedure” CPT® code to indicate that it qualifies as a separately reportable service.

Jun 2nd, 2015 - youngblood 278 

re: Cesarean Delivery & Salpingectomy

Is the salpingectomy for a different reason than tubal ligation? The latter has a different add-on code with C-section.

Jun 2nd, 2015 - kharper 3 

re: Cesarean Delivery & Salpingectomy

Yes, the MD prefers the salp.

Jun 2nd, 2015 - kharper 3 

re: Cesarean Delivery & Salpingectomy

That's what the revenue cycle coordinator & I have been saying...

Thank you for the feedback.

Jun 2nd, 2015 -

re: Cesarean Delivery & Salpingectomy

Take the modifier 51 off and add the modifier 59, the salpingectomy is a seperately and identifiable procedure which is not part of the delivery. Read the guidelines in the CPT® book for modifiers and it will give a full explanation as to how to use modifier 59 when billing for procedures. It can be found on page 483, appendix A in the 2015 Standard edition CPT® book:)

Jun 2nd, 2015 - petunia 195 

re: Cesarean Delivery & Salpingectomy

are you using 58700? That code is designated as a separate procedure and may be why you are being denied.



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