# Thermochoice ablation and cauterization of uterine perforation



## amottice (Sep 11, 2014)

Hello Fellow Coders:  I need your help on two procedures:  Cpt code for thermachoice ablation with laparoscopic guidance(58353 is with a hysteroscope, is this the correct code to use?) and I also need a code for cauterization of uterine perforation.  The only code I see for the cauterization is an unlisted code of 58578.  If we use this unlisted code, do we put our own fee as to what we want to charge for this service or do we submit the code with a zero dollar amount and see what the insurance will pay us according to the operative note submitted? The patient had a Laparoscopic tubal with filshe clips the same day(I have the code for that).  More concerned about the other two.  Thanks in advance for your help coders!!!


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## nsteinhauser (Sep 11, 2014)

Maybe there was a mistake by the computer generated dictation/transcription program.  Are you sure this wasn't supposed to read a "Thermachoice ablation with "hysteroscopic" guidance?"  If it was with a  hysteroscope, then you would use a 58563.  
I haven't found a code yet assigned to cautery of a uterine perforation - maybe someone reading this can add?  But if you end up using an unlisted code, you need to assign a fee/charge for the service.  Most payers won't reimburse a provider anything over the provider's charge amount...even if the allowed amounts are higher per the contract... so if you leave the charge at zero, the payer won't pay you anything.  You'll need to come up with a billed amount.  Hope this helps.


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## amottice (Sep 11, 2014)

This is how the thermachoice ablation reads in op note:" The thermachoice ablation lasted eight m inutes and thought the entire ablation there was a laparoscopic guidance and visualization to make sure the uterus was in no contact with other structures in the patient's pelvis". One more  thing please:  In the op note an attempt was made to do the Novasure ablation, twice this was attempted, and then it was decided at that time to proceed with the thermachoice ablation.  Can I bill 58563 twice with mod 53 appended to the one for the attempt of the Novasure?


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