# Hysterosalpingogram with selective catheterization



## sukalyan (May 22, 2008)

Procedure: hysterosalpingogram with selective catheterization.
      Indication: infertility.
      Complications: none.
      Anesthesia: none.
      Contrast: Ultravist 300, 30-ml.

      Fluoroscopy time: 94 seconds.

      Immediately prior to the procedure, a urine pregnancy test was
      performed.
      Urine pregnancy test result: negative.

      Procedure description: The patient was placed in lithotomy
      position and a vaginal speculum was inserted. After cleansing the
      external os with Betadine solution, the cervical os was cannulated
      with a 7F hysterosalpingography catheter. The catheter balloon was
      inflated and contrast injection was performed with fluoroscopic
      control. There was opacification of the uterine cavity. There was
      no opacification of the right fallopian tube. There was no
      opacification of the left fallopian tube. The balloon was then
      deflated and catheter was removed. A 5F Berenstein catheter was
      then used to perform selective catheterizations. Selective
      contrast injections were performed with the catheter positioned at
      the junction of the right cornual portion of the uterine cavity an
      right fallopian tube and left cornual portion of the uterine
      cavity and left fallopian tube. The catheter was removed.  The
      patient tolerated the procedure well.

      Findings: The size and shape of the uterine cavity was normal. The
      uterine cavity was displaced toward the right hemipelvis. There
      was opacification of the right fallopian tube. The right fallopian
      tube was normal in course and caliber with free peritoneal
      spillage. There was no opacification of the left fallopian tube,
      despite selective catheterization.

      IMPRESSION:
      1. Normal uterine cavity. Uterine cavity displaced toward the
      right hemipelvis.
      2. Normal appearing left fallopian tube with free peritoneal
      spillage. Selective catheterization was required to achieve
      opacification of and spillage from the right fallopian tube.
      3. Proximal left fallopian tube occlusion, despite selective
      catheterization.

      Fluoroscopically-guided guidewire recanalization of the left
      fallopian tube may be considered, if indicated.
      catheterization.

      Fluoroscopically-guided guidewire recanalization of the left
      fallopian tube may be considered, if indicated.

Can CPT 58340 along with 58345 be coded for the above case?  Thank you for your time.


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## ajmtucker (Jul 10, 2008)

only 58345 can be reported - the the other code is used for diagnosic procedures. 58345 includes everything in 58340.


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