# Hysteroscopy question.



## cwpierce (Oct 24, 2012)

I have a physician trying to bill for Hscopy with D&C (58558), LOA (58559), and division/resection of the intrauterine septum (58560). According to Edits none of these unbundle to one another. According to my gut feeling, I would think 58558 would be global to the other two due to it being a biopsy and I would think that 58559, the LOA would be global to 58560, the division of the intrauterine septum. Any thoughts or guidence would be greatly appreciated.


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## preserene (Oct 24, 2012)

I would not bundle 58560 with 58558 even if the cci suggests. Both these procedures are clinically and procedurally distinct and separate surgical procedures  and with separate and distinct diagnosis. They have separate codes of their own and not separate procedures either. ( Only the diagnosis code bundled and of course some of the minor things that are already in the general lst of bundling events in hysteroscopic procedures like,for eg, Bladder Catheterization,

§ Examination under anesthesia – which includes visualization of the vagina & cervix

§ Application of a tenaculum and dilation of the cervix, or cervical canal

§ Insertion of the hysteroscope and distending media such as gas or fluid

§ The inspection of the uterine cavity)

I would report them separately with modifier-59. 
If the payer refuses, we would have to talk to them and explain and preferably doctor's detailed procedural notes.


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## cwpierce (Oct 30, 2012)

Thank you, that really helps.


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