COBGC Gynecologic Surgical Coding 2 — Questions and Answers
Question 1: A surgeon performs a laparoscopic bilateral salpingo-oophorectomy. Which CPT code is most appropriate?
- 58661 (Correct answer)
- 58700
- 58720
- 58925
Correct answer: 58661
CPT 58661 describes laparoscopic removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).
Question 2: When coding a radical hysterectomy with bilateral lymphadenectomy, what is the correct approach for the lymphadenectomy?
- Bill it separately using an add-on code (Correct answer)
- It is bundled into the radical hysterectomy code
- Report it with modifier 51
- Use an unlisted procedure code
Correct answer: Bill it separately using an add-on code
Pelvic lymphadenectomy performed with radical hysterectomy is reported separately using the appropriate lymphadenectomy add-on or standalone code.
Question 3: Which CPT code represents a vaginal hysterectomy for a uterus weighing more than 250 grams?
- 58260
- 58290 (Correct answer)
- 58262
- 58294
Correct answer: 58290
CPT 58290 is used for vaginal hysterectomy when the uterus weight exceeds 250 grams.
Question 4: A patient undergoes laparoscopic cystectomy of a right ovarian cyst. The cyst ruptures during removal. How does this affect coding?
- Add modifier 22 for increased complexity
- No change; code the procedure as planned (Correct answer)
- Downcode to a lesser procedure
- Use an unlisted laparoscopy code
Correct answer: No change; code the procedure as planned
Intraoperative complications like cyst rupture do not change the procedure code; the surgeon's intended and completed procedure determines the code.
Question 5: CPT code 57267 is an add-on code used in conjunction with which procedure?
- Anterior and/or posterior colporrhaphy (Correct answer)
- Hymenectomy
- Vaginal hysterectomy
- Colposcopy with biopsy
Correct answer: Anterior and/or posterior colporrhaphy
CPT 57267 (insertion of mesh or other prosthesis) is an add-on code used with anterior and/or posterior colporrhaphy codes.
Question 6: What modifier should be appended when the same surgeon performs a diagnostic laparoscopy that leads to an immediate therapeutic laparoscopy during the same session?
- Modifier 51
- Modifier 59
- No modifier needed; only report the therapeutic procedure (Correct answer)
- Modifier 22
Correct answer: No modifier needed; only report the therapeutic procedure
When a diagnostic laparoscopy converts to a therapeutic procedure, only the therapeutic (surgical) laparoscopy is reported, as the diagnostic portion is bundled.
Question 7: A surgeon performs a LAVH (laparoscopically assisted vaginal hysterectomy) with removal of tubes and ovaries. Which code set best describes this?
- 58550 + 58661
- 58553 + 58661
- 58552
- 58554 (Correct answer)
Correct answer: 58554
CPT 58554 describes LAVH with removal of tube(s) and/or ovary(s) for a uterus greater than 250 grams.
COBGC Gynecologic Surgical Coding 2
A surgeon performs a laparoscopic bilateral salpingo-oophorectomy.
Which CPT code is most appropriate?