Ob-Gyn Coding Alert

Question: One of our doctors performed a loop electrode excision procedure (LEEP) to remove a polypoid mass from the ectocervix. The mass was described as an endocervical polyp with nabothian cyst formation, chronic cervicitis. How should we code this?          

Wisconsin Subscriber
 
Answer: Code 57522 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision) describes the removal of the ectocervix, transformation zone and all or part of the endocervix.
     
Polyp removal would not be coded using 57522, even though the loop was used to excise it.
     
The more accurate code is 57500 (Biopsy, single or multiple, or local excision of lesion, with or without fulguration [separate procedure]).
     
If the physician believes that the procedure was more extensive than usual, append modifier -22 (Unusual procedural services) and submit supporting documentation.