Ob-Gyn Coding Alert

Question: What is the code for cervical cone biopsy done with LEEP? Should I use 57522?


Texas Subscriber

Answer: You should only use 57522 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision) for a conization of the cervix, not a cervical cone biopsy.

When the ob-gyn performs a conization, he removes all of the transformation zone and some or all of the endocervix.
 
When the ob-gyn performs a cone biopsy, he stops at the transformation zone. So if the ob-gyn performs a biopsy along with a colposcopy, you should report 57460 (Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy[s] of the cervix). The reason is that a loop electrode can excise a "cone" from the cervix as a biopsy sample.

If the ob-gyn did not perform a colposcopy, you should report 57500 (Biopsy, single or multiple, or local excision of lesion, with or without fulguration [separate procedure]). Make sure to check with the physician or documentation to find out if the procedure was a biopsy or a true conization.