Ob-Gyn Coding Alert

Question: How do I code for a laparoscopically assisted transvaginal hysterectomy and endometrial ablation?

Florida Subscriber

Answer: If in addition to removing the uterus the physician also removed endometrial implants through the laparoscope, code 58550 (laparoscopy, surgical; with vaginal hysterectomy with or without removal of tube[s], with or without removal of ovary[s] [laparoscopically assisted vaginal hysterectomy]) and 58662-51 (laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method).

If the physician did the laparoscopically assisted hysterectomy, but also did a hysteroscopic ablation of endometriosis, the payer will not reimburse for both procedures because the physician would be scraping the
inside of the uterus and then removing it. This is another example of when it pays to check with the surgeon if you have any questions about what was done, rather than trying to interpret an operative report without his or her input.