ries by open surgery, whereas code 58661 is used for laparoscopic removal of the

ovaries. Code
58943 is used for an oophorectomy due to ovarian, tubal or primary peritoneal
malignancy.
When an ovarian malignancy is resected by performing a bilateral salpingo-
oophorectomy
(removal of both fallopian tubes and ovaries) and omentectomy (removal of the
omentum), a
code from the 58950-58952 series is selected.

When wider resection of a tumor is required, codes 58953 and 58954 are used. These
include bilateral salpingo-oophorectomy with omentectomy, total abdominal
hysterectomy,
and radical dissection for debulking of tumors. Code 58954 adds pelvic
lymphadenectomy and
limited para-aortic lymphadenectomy to the description.

Maternity Care and Delivery

Many of the codes in the maternity care and delivery subsection are assigned to
bill for a
package of services. The physician is able to use one code rather than multiple
codes to bill
for the prenatal, delivery, and postpartum follow-up care of the pregnant patient.
Antepartum
care includes the initial and subsequent prenatal history, physical examinations,
recording
of weight, blood pressures, fetal heart tones, routine chemical analysis, monthly
visits up to
28 weeks' gestation, biweekly visits to 36 weeks' gestation, and weekly visits
until delivery.
Additional visit and services beyond these are coded separately with ElM codes or
other
appropriate procedure codes.

Delivery services include admi sion to the hospital, admission history and physical
exami
nation, management of uncomplicated labor, vaginal delivery (with or without
episiotomy,
with or without forceps), or cesarean delivery. Medical problems complicating labor
and
delivery management may require additional resources. When applicable, codes in
either the
medicine section or the ElM section of the CPT code book should be used in addition
to codes
for maternity care.

Postpartum care includes hospital and office visits following vaginal or cesarean
section
delivery. When reporting delivery only services, report inpatient post-delivery
management
and discharge services using the appropriate ElM service codes. Delivery and
postpartum ser
vices include delivery services and all inpatient and outpatient postpartum
services. Postpar
tum care only services (code 59430) include office or other outpatient visits
following vaginal
or cesarean section delivery.
Removal of cerclage suture(s) is coded to 59871. For obstetric placement of
cerclage
sutures, the coder should refer to codes 59320 and 59325 and for nonobstetric
placement to
code 57700.

Antepartum and/or Postpartum Care Only

When the physician provides all or part of the antepartum and/or postpartum care
but does not
perform delivery due to termination of pregnancy by abortion or referral to another
physician
for delivery, the coder should refer to codes 59425-59426 and 59430. The physician
assisting
in the delivery would assign the appropriate delivery-only code. For example, an
obstetrician
is called in to perform an emergency cesarean section on a patient that is not his.
He would
assign code 59514 for cesarean delivery only.

Changes in the treating physician can occur for many reasons during the prenatal
period,
including medical complications, insurance changes, and patient relocation. To
ensure proper
coding, the coder should clarify exactly what services were performed and the
reason they
were terminated or changed. It should be noted that one to three antepartum care
visits
should be coded using the appropriate level of ElM code(s) based on the level of
each visit.