# Intrauterine balloon catheter



## kathleenl (Jan 9, 2012)

Morning,
I am trying to code for the placement of a intrauterine balloon catheter placed under ultrasounic guidance after a hysteroscopic myomectomy.  The only codes I am finding are ablation codes or OB codes and I do not think these are correct.  
Any help or guidence in finding this code is appreciated.

Thanks!
-Kathleen


----------



## ajs (Jan 9, 2012)

kathleenl said:


> Morning,
> I am trying to code for the placement of a intrauterine balloon catheter placed under ultrasounic guidance after a hysteroscopic myomectomy.  The only codes I am finding are ablation codes or OB codes and I do not think these are correct.
> Any help or guidence in finding this code is appreciated.
> 
> ...



Could you post the op note?  I have never heard of placing a balloon catheter after a hysteroscopy so need to see more clearly what was being done.


----------



## kathleenl (Jan 9, 2012)

Thanks for your help!  A few days later, the doctor removed the catheter in the office. 

Large submuscosal fibroid with intramural component located fundal anterior, mid to right portion of the uterus.  Procedure:  The patient under adequate general anesthesia and the patient was placed in dorsal lithotomy position.  Prepped and draped in the usaual sterile manner.  Just prior to entering the operating room, the patient completely voided bladder.  Under transabdominal ultrasound guidance, a diagnosit hysteroscope was placed noting anteflexed anteverted uterus.  The endometrial cavity was noted to have the large submucosal fibroid at the fundus anteriorly right and left.  Bilateral tubal ostia appeared normal.  Endometrial cavity otherwise appeared normal.  Endocervical canal appeared normal.  Then the cervix was dilated again under transabdominal ultrasound and a resectoscope was placed, the fibroid was bisected in the midline.   The outer shell on the right and left side of the midline were then removed.  This all done under transabdominal ultrasond guidance.  The intramural component was removed majority with a very samll remnant left due to the proximity to the outer portion of the uterus and the concern to prevent uterine perforation.  The remnant shell of the fibroid was then coagulated to decrease blood flow, and the endometrial cavity then appeared normal after removing the fibroid remnants and sending that to pathology.  The intrauterine balloon catheter was then placed unter transabdominal ultrasound with no uterine perforation, and the balloon was then insuffilated to 8ml easily.  The single-tooth tenaculum was removed off the anterior lip of the cervix noting good hemostatis.  The tubing was placed in the vagine and the patient tolerated procedure well to recovery room in stable condition.  Is and Os are for glycine 36 , 10 in and 29, 20 out with a deficit of 690 mL of glycine.  The patient tolerated procedure well to recovery in stable condition.


----------



## ajs (Jan 9, 2012)

kathleenl said:


> Thanks for your help!  A few days later, the doctor removed the catheter in the office.
> 
> Large submuscosal fibroid with intramural component located fundal anterior, mid to right portion of the uterus.  Procedure:  The patient under adequate general anesthesia and the patient was placed in dorsal lithotomy position.  Prepped and draped in the usaual sterile manner.  Just prior to entering the operating room, the patient completely voided bladder.  Under transabdominal ultrasound guidance, a diagnosit hysteroscope was placed noting anteflexed anteverted uterus.  The endometrial cavity was noted to have the large submucosal fibroid at the fundus anteriorly right and left.  Bilateral tubal ostia appeared normal.  Endometrial cavity otherwise appeared normal.  Endocervical canal appeared normal.  Then the cervix was dilated again under transabdominal ultrasound and a resectoscope was placed, the fibroid was bisected in the midline.   The outer shell on the right and left side of the midline were then removed.  This all done under transabdominal ultrasond guidance.  The intramural component was removed majority with a very samll remnant left due to the proximity to the outer portion of the uterus and the concern to prevent uterine perforation.  The remnant shell of the fibroid was then coagulated to decrease blood flow, and the endometrial cavity then appeared normal after removing the fibroid remnants and sending that to pathology.  The intrauterine balloon catheter was then placed unter transabdominal ultrasound with no uterine perforation, and the balloon was then insuffilated to 8ml easily.  The single-tooth tenaculum was removed off the anterior lip of the cervix noting good hemostatis.  The tubing was placed in the vagine and the patient tolerated procedure well to recovery room in stable condition.  Is and Os are for glycine 36 , 10 in and 29, 20 out with a deficit of 690 mL of glycine.  The patient tolerated procedure well to recovery in stable condition.



I assume you already are coding for the hysterscopy w/myomectomy and the ultrasound guidance, so the placement of the intrauterine balloon catheter would appear to be part of the overall hysteroscopy procedure.  The only additional charge would be for the balloon catheter itself so that would be billed by the facility.


----------



## kathleenl (Jan 9, 2012)

Yes, I will be coding/billing for the hyst myomectomy w ultrasonic guidance and I was leaning towards coming to the same conclusion re the catheter.  Thanks for your help I really appreciate it!

-Kathleen


----------

