# incision & drainage of cervical cyst?



## laurabee (Jul 9, 2009)

I'm new to OB/GYN and can't figure this CPT out. "Incision and Drainage of Cyst of the Cervix".


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## vikas.maheshwari (Jul 10, 2009)

hi you did not mention the type of cyst.

Just see the solution blow if the cyst is Nabothian cyst. 

No code exists for this type of cyst. Carriers won't reimburse for this cyst because carriers consider it to be a minor condition that does not require any significant work to remove or incise and is therefore just part of the E/M service. 

And many payers do not reimburse ob-gyns for removing this type of cyst without documentation showing significant work. These cysts are very common, and most patients are unaware they have them until their ob-gyn performs a Pap smear and the results point it out. The best advice is to roll it into the E/M service. If your ob-gyn insists on billing, you should use unlisted-procedure code 58999 (Unlisted procedure, female genital system [nonobstetrical]).



Thanks


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## laurabee (Jul 10, 2009)

The doctor didn't specify the type of cyst either, just that it appeared to be infected. 

OPERATIVE FINDINGS:  A 3.5-cm cyst in the anterior lip of the cervix, which appeared to be infected and on cystoscopy, there were multiple petechial hemorrhages in all quadrants of the bladder after hydrodistention.  There were no stones or lesions visualized within the bladder.

TECHNIQUE:  The patient was taken to the operating room where general anesthesia was administered.  The patient was subsequently positioned, prepped, and draped in the usual sterile fashion for vaginal surgery.  A Graves speculum was then introduced into the vagina and 1% lidocaine was then injected into the cervical cyst.  Incision and drainage of the cervical cyst was done with the scalpel.  Purulent exudate was evacuated and subsequently #1 chromic running locking stitch was then used for hemostasis and reapproximation of the tissue.  

I will suggest the unlisted code and see if he wants to bill it. 

Thank you for your help!!


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