# Hysteroscopy with IUD removal



## JulieK (Apr 3, 2014)

I have a question as to how to code a hysteroscopic removal of IUD that is not embedded.  It could not be grasped in the office after two attempts.  US confirmed proper placement of the IUD.  An in office hyseroscopic removal was done.  Would it be proper for me to use the 58562 code although the IUD was not technically embedded.

I would appreciate any thoughts or advice.

Thank you.


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## gena379 (Apr 7, 2014)

We code it as 58301 and add a modifier -22 for the extra work (hysteroscope). We found this information on ACOG.


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## tmerickson (Apr 11, 2014)

Gena379,
Where on ACOG did you get that information?


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## JulieK (Apr 18, 2014)

I would be interested to see where you found the information on the ACOG website too Gina.


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## abctibbett@gmail.com (Apr 23, 2014)

Why couldn't it be grasped? Was the string previously trimmed too short or was it an issue with the patient tolerating the procedure?


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## JulieK (May 13, 2014)

Here is what the record says:  Strings not visible or palpated,  IUD extractor tool inserted into cervical canal and IUD not palpated.  U/S confirmed IUD in place.  Discussed option of hysteroscopy to remove IUD and will proceed with hysteroscopic removal of IUD. 

And then I have the procedure note where the IUD was removed with the hysterocopic procedure on a subsequent date.  

So, the IUD in not imbedded but just could not be grasped and was removed by hysteroscopic procedure.  How would this be coded?  Any advice?  Thanks.


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## gena379 (May 23, 2014)

tmerickson said:


> Gena379,
> Where on ACOG did you get that information?



http://www.acog.org/~/media/Departments/LARC/LARCBillingQuiz.pdf?dmc=1&ts=20140523T1637387969

Page 5 under scenario 4 "Missing String".


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## ObGynCPC0910 (Jul 26, 2017)

*Link update*



gena379 said:


> http://www.acog.org/~/media/Departments/LARC/LARCBillingQuiz.pdf?dmc=1&ts=20140523T1637387969
> 
> Page 5 under scenario 4 "Missing String".




This document has since been moved/removed from the ACOG website.  I think this is the same document via the LARC First website:
http://www.larcfirst.com/resources/larcfirst/Financial_Resources/larc_billing_coding/LARC_Billing_Quiz.pdf


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## acf7575 (Sep 21, 2022)

*Updated link: https://www.acog.org/education-and-events/emodules/larc-billing-quiz-series/intrauterine-device
However this reference does not really address the fact it was removed via hysteroscopy.  *


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## klapetri@ilovemygyn.com (Sep 21, 2022)

To my understanding IUD insertion and device is covered under larc. For example, if a patient delivers 8/1/2022, and returns for post partum appointment 8/29/2022 in office setting (pos 11)- We can bill for iud device an iud insertion
Is that correct? Also, is there a document that clearly states that?


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