Forum - Questions & Answers

Mar 17th, 2010 - KellyM 1 

Hysteroscopy and endometrial ablation

I am trying to determine the proper way of coding the following surgery. Should I be using 58563 (hysterscopy w/ablation) or should I use 58558 for the hysteroscopy portion and 58353 (Endometrial ablation without hysteroscopic guidence) for the ablation?

OPERATION
Fractional dilatation and curettage, diagnostic hysteroscopy, NovaSure
endometrial ablation, and polypectomy.

Cervix was visualized, grasped with a single-tooth tenaculum, and paracervical block was placed. Cervical length was ascertained and the total uterine length
was ascertained. The cervix was then dilated to 16 French and endocervical
curettage was performed. The diagnostic hysteroscope was introduced under
direct visualization. The findings were as noted. On removing the
hysteroscope, a small flap of polypoid-type tissue was noted. This was
initially removed with the small Randall-Stone forceps and then followed by
curettage. Repeat hysteroscopy was performed and showed all polypoid
tissue had been removed. At this time, the NovaSure ablation kit was then opened. The settings were made and the NovaSure array was deployed and observed. It looked to be normal. It was withdrawn back into the device and it was placed into the uterine cavity and deployed again. The maximum width was obtained using the usual maneuvers then a cavity check was performed and passed. The coagulation therapy time was begun and at the end of the coagulation, time was taken to allow the NovaSure array to cool before it was withdrawn into the device, at which time it was removed from the uterus. Follow up hysteroscopy showed excellent burn in all areas."

Mar 17th, 2010 - nmaguire   2,606 

Opinion

Do not separately bill code 58558. If the hysterscopy was diagnostic and then withdrawn and NovaSure then performed- code 58353 (includes 58558) and 58555-59.



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