Melanie Witt,, RN, CPC, MAMs. Witt, former program manager in the department of Coding and also Nomenclature in ~ the American university of Obstetricians and Gynecologists, is an live independence coding and also documentation consultant. Reimbursement Adviser mirrors the most frequently accepted interpretations the CPT-4 and also ICD-9-CM coding. Once in doubt ~ above a coding or billing matter, check with her individual payer.
You are watching: Transposition of the left ovary cpt code
Q ns performed surgical treatment for torsion that the ovary utilizing the adhering to procedures: diagnostic laparoscopy, exploratory laparotomy, detorsion of left tube and ovary, bivalve that left ovary, and left oophoropexy.
Two coding scenarios have been suggested: The very first is 58925 (Ovarian cystectomy, unilateral or bilateral) 58825 (Transposition, ovary
), and 49320 (Laparoscopy, abdomen, peritoneum, and also omentum, diagnostic, through or without arsenal of specimen by to brush or washing). I hesitate to usage these, though, due to the fact that an ovarian cystectomy was not performed and the tube and ovary to be detorsed, no transposed elsewhere.
The second option is 49000 (Exploratory laparotomy, exploratory celiotomy with or there is no biopsy
) with modifier -22 (unusual procedural services), to add 49320.Are these appropriate?
A The diagnostic laparoscopy, presumably performed to evaluate the problem, have the right to be coded together 49320—but be conscious that you might not obtain reimbursement if friend planned to carry out the surgery laparoscopically, then converted come an open up procedure.
The exploratory laparotomy is not separately billable, because you’ll be billing for open surgical procedures. As soon as this happens, the exploratory i do not care integral to the operation technique.
Next is detorsion the the left ovary: CPT walk not have actually a password for this.
You then bivalved the ovary, which is analogous come performing a wedge resection, code 58920 (Wedge resection or bisection of ovary, unilateral or bilateral).
Finally, for the oophoropexy, you room correct that password 58825 is no applicable. If you had moved the ovary the end of harm’s means due to radiation treatment, the procedure is described as transposition that the ovary and also 58825 is reported. In this case, however, ns guessing friend sutured the ovary in place so it can no much longer twist. Choose the detorsion, CPT has no code for this.
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Your coding choices are limited, yet I would suggest 58920-22—which covers the bivalving, detorsion, and oophoropexy—plus 49320-59 for the diagnostic laparoscopy. (The “distinct procedure” modifier shows that the laparoscopy was not integral to the remainder of the procedure.)
As much as diagnosis, the code attached to 58920 is 620.5 (Torsion the ovary, ovarian pedicle, or fallopian tube), or 752.0 (Congenital anomalies of ovaries) if you recognize the difficulty is congenital. Think about a different diagnosis for the laparoscopy, such as lower quadrant abdominal pain (789.03 or 789.04) or ovarian pain (625.9). Finally, add V64.41 to indicate the conversion from laparoscopy come an open up procedure.