Ob-Gyn Coding Alert

Question: The physician performed a diagnostic laparoscopy with chromotubation and a hysteroscopy with an attempt at cannulation. Chromotubation showed patency of left tube. Is there a CPT code for cannulation for tubes or is there another term for cannulation? The diagnosis was patency of at least the left tube/proximal fallopian tube obstruction based on hysterosalpingogram.

Montana Subscriber

Answer: Since this was an attempted cannulation via the hysteroscope, 58555 (hysteroscopy, diagnostic [separate procedure]) is the best code to use. You can also code for the diagnostic laparoscopy (49320, laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]) and the chromotubation (58350, chromotubation of oviduct, including materials) since it was done for diagnostic reasons. You will notice that   58555 and 49320 are designated as "separate procedure." This means that the payer may want to see modifier -59 (distinct procedural service) appended to the hysteroscopy code to bypass any bundling edits they are using.