Can 59812 58660 49322 be billed together?

Can anyone assist with this surgery? I am new to OB coding and am not sure. My 58660 paid but the 49322 is denying. There are no CCI Edits, but the codes are on the MUE Edits.....

Dx’s 634.11 614.9 620.2

Indication for surgery: Incomplete abortion and large cystic pelvic mass of unknown etiology on abnormal pelvic ultrasound. Suspicious for hemorrhage corpus luteum or ectopic pregnancy..

Pre-op and post op dx…..Incomplete spontaneous abortion with delayed hemorrhage, large cystic pelvic mass, pelvic adhesive disease possible heterotopic pregnancy.

Operation: Diagnostic laparoscopy with video with the following: Left ovarian cystotomy and enterolysis
Suction dilation and curettage

Thanks

re: Can 59812 58660 49322 be billed together?

I think you are billing for an incorrect procedure 49322. Per the CPT® and the Coders Desk reference you are billing for two laparoscopic procedures which is double billing. 49322 is for the aspiration of an ovarian cyst single or multiple or to collect fluid for culture. In 58660 the provider is again performing a laparoscopc surgical cutting/releasing of lysis/adhesions surrounding the oviaries and or fallopoian tubes with the assistance of a fiberoptic laparscope. You cannot bill for both laparscopes. The word enterolysis leads you to look at the laparoscopy, surgical, enterolysis(freeing of intestinal adhesions) 44180, under that description in the CPT® book it states for laparascopy with salpingolysis, oviariolysis, use 58660. I would stay away from the digestive part of the CPT® book when you are performing gyn surgery. The 59812 is correct for the Suction dilation and curettage. Your claim should be billed as follows 58660 and 59812. I would be careful also in referencing the medical terminlogy terms as a cysotomy is a surgical incision onto the gallbladder or urinary bladder. This helps determine alot as to how to code for procedures. I would look up the term on line or in a medical dictionary.

re: Can 59812 58660 49322 be billed together?

Thank you for the clarification. I was thinking that 49322 was part of the 58660 but needed reassurance.


Thanks.

re: Can 59812 58660 49322 be billed together?

You should always reference a CPT® book, preferably an up to date one for coding as when your are performing surgical procedures you need to understand how to bill for the correct procedure being performed and on the correct body system. You should never assume that because the provider provided you with the CPT® codes or how someone else was billing that its correct. An Certified coder would be your best bet in helping you out as to how to bill correclty, never assume, thats how audits happen:)

re: Can 59812 58660 49322 be billed together?

Thank you, I am a CPC, but am new to obgyn coding and was uncertain. That is why I posted the question. Was looking for assistance and guidance.

re: Can 59812 58660 49322 be billed together?

OBGYN coding is easy, stick to the OBGYN section of your CPT® book and the ICD-9 book and you shouldn't have a problem. Took a postion about a 2yrs ago doing OBGYN coding and found it to be very easy. You aslo might want to get the ACOG(American Congress of Obsetricians and Gynecologists) coding manual for reference, it will have every code that is used in the OBGYN speciality and how to bill for them correctly. It will also tell you the RVU value of a code and whether two codes are inclusive of each other and can be billed together. I will help you as much as I can also, but as a CPC you should really read up on the OBGYN codes and make yourself very familiar with them. A Coders Desk Reference for procedures is also a helpful tool for coders. :)

re: Can 59812 58660 49322 be billed together?

Thank you for all your help. It is greatly appreciated and well noted. Have a good day.