# Help - Looking for some input



## Leandra (Dec 14, 2011)

Looking for some input on how to code the following op note:  I have 58558 for the hysteroscope with D&C and 58670 for fulguration of oviduct(s) - I'm thinking I need to use the unlisted laparoscopic procedure for the removal of the Filshie clip - never coded this before. The clip is not stated as being "impacted" in the body of the notes so I didn't go with 58562 instead of 58558. Or, is the removal of the clip considered part of the fulguration? Any other ideas/suggestions/input would be great.  Thanks in advance!

PREOPERATIVE DIAGNOSES:  
1.	Chronic pelvic pain.
2.	Dysfunctional uterine bleeding.  
3.	History of carcinoma in situ.

POSTOPERATIVE DIAGNOSES:  
1.	Chronic pelvic pain.
2.	Dysfunctional uterine bleeding.  
3.	History of carcinoma in situ. 
4.	Pelvic adhesions and a left Filshie clip was noted on the proximal end of the distal segment of tube.

OPERATIVE PROCEDURES:  
1.	Laparoscopic left tubal removal of Filshie clip or foreign body.  
2.	Fulguration of the left tube following removal of the Filshie clip.  
3.	Lysis of adhesions.
4.	Hysteroscope with a dilatation and curettage.


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## ajs (Dec 16, 2011)

Leandra said:


> Looking for some input on how to code the following op note:  I have 58558 for the hysteroscope with D&C and 58670 for fulguration of oviduct(s) - I'm thinking I need to use the unlisted laparoscopic procedure for the removal of the Filshie clip - never coded this before. The clip is not stated as being "impacted" in the body of the notes so I didn't go with 58562 instead of 58558. Or, is the removal of the clip considered part of the fulguration? Any other ideas/suggestions/input would be great.  Thanks in advance!
> 
> PREOPERATIVE DIAGNOSES:
> 1.	Chronic pelvic pain.
> ...



The removal of the clip is just part of doing the fulguration of the tube...included.


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