Getting The Best Myomectomy Medical Billing Reimbursements

If you work in the billing department of a gynecologist’s office, myomectomy coding won’t be unknown to you, but in order to reap the maximum benefits of this procedure, there are a few key components you should keep in mind when doing medical billing for a myomectomy procedure.

First of all, there are two major ways to perform a myomectomy: open and laparoscopic. Likewise, there are two sets of current procedural terminology codes that are acceptable to use for myomectomies in medical billing.

If you perform a laparoscopic myomectomy, you should either use the medical billing code 58545 (Laparoscopy surgical, myomectomy, excision; 1 to 4 intramural myomas with total weight of 250 grams or less and/or removal of surface myomas), or 58546 (.5 or more intramural myomas and/or intramural myomas with total weight greater than 250 grams). If you were doing medical billing for an open myomectomy, you would use the current procedural terminology codes 58140-58146.

When performing a laparoscopic myomectomy, the two most important factors in medical billing are size of the myoma and weight. This means that it is imperative to include this information with your medical billing. The surgeon should be instructed on the importance of accurate and complete documentation. Failure to include such necessary information could lead to medical billing denial.

Another important factor of myomectomy medical billing is the diagnosis code. Since the current procedural terminology code must match the ICD-9 code, you should wait until pathology reports return to finalize your medical billing. If you code your medical billing prior to pathology reporting you would have to use the ICD-9 code 218.9 (Unspecified leiomyoma of uterus). Be certain to not use an unspecified code or you run the possibility of a reduce or denied claim. Make sure your documentation is ironclad and matches your coding and you’ll receive the maximum benefit every time!

View all Articles by: Melissa Clark, CCS-P