# Hysteroscopy billing with other procedures



## tlm5506 (Apr 19, 2012)

Hi everyone.
I apologize if this is a question that has been answered previously, but I am new to OB/GYN billing.

The physicians I bill for all state in their op notes when doing hysteroscopies that they remove the scope before doing any other procedure, such as a D&C and/or endometrial ablation. After the procedure is finished, they re-insert the scope. I am confused as far as billing for this. Do I use the hysteroscopy codes (58558-58563) even though they are not utilizing the scope during the procedure, or do I code for D&C (58120) and/or endometrial ablation (58353) and then use code 58555 with a modifier? I know that code 58353 specifically states without hysteroscopic guidance. 

Also, sometimes the physicians are doing LEEP procedures along with a hysteroscopy. Again, do I use code 57461 or 57522? They are not utilizing the scope during the procedure. They only insert it before and after the procedure is finished.

Any help will be much appreciated!


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## nsteinhauser (Apr 20, 2012)

I use the hysteroscopy codes - 58563 for the ablation, etc.  They can't have the scope in the uterine cavity at the same time they do the ablation or at the same time they are using instruments to do a currettage, etc.  But they use the scope to view before and after so you go with the hysteroscope codes.  
And one more hint although you may already know this - if the surgeon performs a hysteroscopic endometrial ablation AND a hysteroscopic D+C in the same surgery,  NCCI edits prohibit you from coding both. Just code the hysteroscopic endometrial ablation.
Hope this helps.


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## tlm5506 (Apr 21, 2012)

Thanks for the reply. I was leaning towards the hysteroscopy codes, but I wanted to get some more opinions.


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