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June 2004 · Vol. 16, No. 6

REIMBURSEMENT ADVISER

Low payment for cystectomy with oophorectomy

MELANIE  WITT,  RN, CPC, MA

Q

My physician removed a patient’s ovaries and also performed a dilation and curettage. We coded these procedures as 58661 (Laparoscopy, surgical; with removal of adnexal structures [partial or total oophorectomy and/or salpingectomy]) and 58120-51 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]; multiple procedure), but received extremely low reimbursement.

The operative report stated extensive work was involved. An 8-cm ovarian cyst was excised, and some cystic fluid aspirated. Should we appeal? Also, should we have added modifier -22 (unusual procedural services) to 58661?

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