# gyn surgery question



## deidrahofer (Oct 2, 2008)

Patient has a cystourethroscopy and then a total hysterectomy.  Code both?  I got 58150 and 52000.  What do you think?

Thank you

Deidra 
CPC-A


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## Beany011178 (Oct 2, 2008)

I HAD THIS SAME QUESTION THAT I EMAILED ACOG AND THIS IS THE RESPONSE I GOT.  HOPE THIS HELPS.



Cystoscopy (52000) is often performed during or following a primary procedure in order to ensure proper placement of for example, surgical sutures and to ensure that the urethra and bladder have not been perforated.  Since cystoscopy is considered clinically integral to the successful outcome of the primary procedure it is not reported separately.



However, when this service is performed for a medically necessary reason it may be reported separately.  While not required, it may help payers to better understand the medical necessity of performing a cystoscopy (52000) if it is linked to a different ICD-9 code (when appropriate) than the one used for the primary procedure.  



Further, the modifier -59 (distinct procedure) should be appended to code 52000.  In this instance, the modifier -59 indicates that code 52000 was not performed as a component of the primary procedure and should be recognized as being distinct and separately reportable.


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