Wiki Dx lap including lysis of adhesions

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Patient was scheduled for a dx laparoscopy to evaluate left ovary for potential torsion or cyst. As he started the procedure (per OP note), he encountered adhesions involving the omentum to the anterior abdominal wall and small bowel to the fundus of the uterus. He did the lysis of adhesions. Once that was taken care of, it was determined that ovaries and tubes were fine. Would this be coded as lysis of adhesions (58660) or would it be coded as a dx lap?
 
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I only code gyn surgeries and agree with @Orthocoderpgu. You code what was done.
58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
If the provider performed lysis of adhesions of the ovary and/or fallopian tubes via laparoscopy, that is the correct code. However, your very brief description does not state ovary or fallopian tube adhesions. You state omentum to abdominal wall and small intestine to uterus. You may want to consider laparoscopic lysis of intestinal adhesions since there is no mention of salpingolysis or ovariolysis.
 
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csperoni said:
I only code gyn surgeries and agree with @Orthocoderpgu. You code what was done.
58660 Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) (separate procedure)
If the provider performed lysis of adhesions of the ovary and/or fallopian tubes via laparoscopy, that is the correct code. However, your very brief description does not state ovary or fallopian tube adhesions. You state omentum to abdominal wall and small intestine to uterus. You may want to consider laparoscopic lysis of intestinal adhesions since there is no mention of salpingolysis or ovariolysis.
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This is what was also confusing me. This is what the op report states (i'll include parts that i believe are more relevant). I believe you are right as to considering the code for intestinal adhesions.

Findings: Adhesions involving the omentum to the anterior abdominal wall, adhesions involving the small bowel to the fundus of the uterus. Adhesions involving the rectosigmoid colon to the right lateral aspect of the uterus. Brownish green- colored fluid identified in the anterior cul-de-sac. Filmy adhesions involving the uterus to the posterior cul-de-sac. Hemostasis. Normal- appearing left ovary with a small simple cyst. Normal-appearing left fallopian tube.

Procedure detail(only relevant part in regards to this question)-At this point the survey of the pelvis was performed. The adhesions involving the omentum to the anterior abdominal wall was then separated with the use of a LigaSure device. After completion of this portion, attempt to restore normal anatomy was performed. Given the area of interest within the left pelvis was obscured by adhesions, a suction irrigator as well as an atraumatic grasper were used to perform traction/counteraction as well as use of hydrodissection to release the adhesions. The left ovary and fallopian tube were then elevated from the pelvis and carefully evaluated. No evidence of torsion was identified at the left infundibulopelvic ligamen. A normal appearing ovary in color and size was noted. Normal appearing left fallopian tube as well.
 
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