Medical Billing CPT found for Transposition of Ovary

Medical Billing CPT found for Transposition of Ovary

There are many procedures in which there is no particular medical billing code to represent it. For instance, an Oophoropexy is usually performed for radiation therapy, but what if it were performed for polycentric ovarian syndrome? Is there a CPT code to represent this? Knowing your options is an important trait in the medical billing world.

In the oophoropexy example above, some medical billing staff members may use the current procedural terminology code 58825 (Transposition, ovary). Unfortunately, they would be incorrect. The definition of transposition is when an ovary is moved due to radiation therapy. Since radiation therapy is not being performed, it is not appropriate to use the code in medical billing.

Since there is no specific medical billing code to utilize in this example, an unlisted current procedural terminology code is in order. 58679 (Unlisted laparoscope’s procedure, oviduct, ovary) is the correct code to use in this case. You would need to supply accurate ICD-9 codes and explanatory documentation with your medical billing.

If there is another procedure performed in conjunction with the oophoropexy, however, another policy is in order. You would use the current procedural terminology code of the other procedure, and attach a modifier 22 to the end. This means: Unusual procedural services. An oophoropexy performed for polycentric ovarian syndrome warrants an unusual procedural service. Also be aware that your modifiers no longer need to be preceded by hyphens.

One factor to always remember when coding is to never report a CPT that doesn’t completely describe the service you are providing. There is no reason to force a fit if it is not there. If there is no medical billing code to match a procedure, use the unlisted procedure code and provide explanatory documentation with your claim.

View all Articles by: Melissa C. - OMG, LLC. CEO