# Failed Essure



## theralee03 (Aug 4, 2011)

I have a Dr that did a laparoscopic removal of an essure coil because it perforated the tube does anyone know the correct cpt code to use?


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## preserene (Aug 12, 2011)

*49325 *with removal of intraluminal obstructive material (here it is Essure coil in the lumen of fallopian tube) which is obsructing the lumen  of FT- a sort of an obstructing foreign body (thouhg it was an intentional placement before). And an appropriate ICD code.

I even thoght of the Essure was removed with a hysteroscope then code 58562 or else 57415, along with this use 996.32,  a post procedural complication code and E947.9 .
But these Cpt codes are not appropriate for Laparoscopic which is the main stay procedure here.


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## smmilen (Aug 16, 2011)

Reviewing the CPT Assistant Archive from March 2000 which covered changes to laparacopy codes, I think I'd be inclined to go with 58562. The laparacopic/endoscopic bit would be considered integral the way interpret the guidelines. I'd love to know what other folks think though.


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## preserene (Aug 16, 2011)

Laparoscopy is abdominal approach and hysteroscopy is essentially vaginal approach and it cannot be used abdominally. Hysteroscopy do not involve invasive(INCISIONAL OR BREAKTHROUGH)) approach nor producing pneumoperironeum like installation which are invasive.
Will the endocsopy rule obliterate the importance of approach and the route of entry in OBGYN?
I understand and it makes sense when we use the laparoscopic approach for DeVanci procdures because the code are not yet available for it an dithe approach  as well as invasiveness
Could any one validate authentically with references for the lap, codes being used in the place of hysteroscopic procedures for reasons of nonavailability of code and vice versa, please?


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