Separate procedure

Hello everyone. I need help with a very basic question, but I am just not sure.
I code for an ASC and we had a patient that had a Laparoscopic fulguration of endometriosis and lysis of adhesions.
The adhesions extended from the right broad ligament across the uterine fundus into the left round ligamnet to the anterior adominal wall. According to the CPT manual, code 58660 (lysis of adhesions) states that it is a separate procedure. Because I am using 58662 for the endometriosis, do I use code 58660 with 59 modifier or do I not use it because they are in the same group and this is the separate procedure? I am just not quite sure what to do?
Thanks in advance for your help.

Darlene Britton, CPC
Montgomery, AL

Separate procedure

I am assuming you are submitting the physician bill.

This kind of question requires access to the NCCI edits. When you put in 58660 and 58662 you find that 58660 is a component code of 58662 and may not be billed with any modifier. I use codecorrect.com to look these up. There is a monthly fee involved, but well worth it.

separate procedure

Thank you for your response. That was the way that I went. Our ASC is not allowed an encoder of any kind but I do have access to the NCCI edits. Should it be my rule of thumb to use that for all insurances M/Care, BC/BS alike as well as other commercial?
Darlene

separate procedure

I would check the NCCI edits, and submit claims based on their edits. It also is helpful in knowing what to appeal. If you billed those two codes together, and the insurer denied it, there wouldn't be any reason to appeal. However, if the insurer denies procedures that aren't bundled per NCCI, then you have a basis to appeal.