# Surgery coding question



## dawn1170 (Aug 19, 2008)

I have an op note where a physician performs a Hysteroscopy resection of submucosal fibroids then due to excessive bleeding the physician had to perform a TAHBSO. The physician clearly documents that we had completed the resection of the fibroids without difficulty and instantaneously, a large amount of heaving bleeding was noted, attemptes made to control bleeding unsuccessful and elected to proceed with TAHBSO. 

Does anyone have any advice on how to code this procedure? 
I was thinking:  58150
                      58561-51 or 59

Thanks in advance, 

Dawn


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## garmab06 (Sep 8, 2008)

There are no edits to bill for the procedures, so you can bill the 58561 with the original code of bleeding and add v64.41 that turned to open procedure.
 58150
 58561 -59-51   
 it depends on the Payer to add the modifier 59


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## KimberlyLanier (Sep 18, 2008)

*Hysteroscopy*

I have an OP Report and in the body of the OP Report the Dr. states that the Hysteroscopy was inserted then it was removed then a D&C was done then the Hysteroscopy was reinserted.  

I am coding the Hysteroscopy as a Diagnostic Hysteroscopy because it does not state that the D&C was done by Hysteroscopy.  




Thanks


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## KimberlyLanier (Sep 24, 2008)

*Hysteroscopy*

Hysteroscopy 

--------------------------------------------------------------------------------

I have an OP Report and in the body of the OP Report the Dr. states that the Hysteroscopy was inserted then it was removed then a D&C was done then the Hysteroscopy was reinserted. 

I am coding the Hysteroscopy as a Diagnostic Hysteroscopy because it does not state that the D&C was done by Hysteroscopy. 

I know that usually when a Hysteroscopy and a D&C is done by Hysteroscopy the Dr. will state that it is done by Hysteroscopy. I do Anesthesia Coding and would like to know the answer.


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## mbort (Sep 24, 2008)

Year: 2003 

Issue: May 

Pages: 19 

Title: Surgery/Female Genital System, 58558, 58120 (Q&A) 

Body: Coding Consultation:Questions and Answers

Question

How should a hysteroscopy followed by a polypectomy and a D&C (not performed through the scope) be reported? The physician dilates the internal cervical os and a hysteroscope is inserted in the endometrial cavity. An examination through the scope is performed. After the scope is removed, multiple polypectomies are performed, as well as gentle curettage of the cavity walls. Should both codes 58558, Hysteroscopy surgical; with sampling (biopsy) of endometrium and/or polypectomy with or without D&C, and 58120, Dilation and curettage, diagnostic and/or therapeutic (nonobstetrical), be reported? Please advise on the correct coding.

AMA Comment

Hysteroscopy followed by a polypectomy and D&C, which are not performed through the hysteroscope, should be reported with code 58558, Hysteroscopy surgical; with sampling (biopsy) of endometrium and/or polypectomy with our without D&C. It would not be appropriate to separately report codes 58558 and 58120, as code 58558 includes both.


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## KimberlyLanier (Oct 6, 2008)

*Hysteroscopy*

Mbort,

Even if the Dr. states that Hysteroscopy was done, removed then the D&C was done and then the Hysteroscopy was reinserted? But no polypectomy was done?  It should be coded as 58558?  

Thanks
Kim


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## pswanson (Nov 22, 2008)

*D&C post elective abortion.*

Patient had an elective abortion four days ago and now presents with bleeding and retained products of conception. I used 635.11 for the dx., however what CPT procedure and ICD-9-CM procedure codes should be used? (Suction D&C).


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