Ob-Gyn Coding Alert

Question: What is the CPT code for a hysteroscope and Novasure endometrial ablation? Our ob-gyns are doing this procedure in the office.


Ohio Subscriber

Answer: When your ob-gyn uses a hysteroscope any time during the session, you should report 58563 (Hysteroscopy, surgical; with endometrial ablation [e.g., endometrial resection, electrosurgical ablation, thermoablation]). 

You may notice, however, that although the National Correct Coding Initiative bundles a diagnostic hysteroscopy (58555, Hysteroscopy, diagnostic [separate procedure]) into 58353 (Endometrial ablation, thermal, without hysteroscopic guidance), you can still use modifier 59 (Distinct procedural service) to bypass this edit, as long as you have supporting documentation. So if the surgeon does a diagnostic hysteroscopy that is not related to the ablation procedure, you have the potential to bill 58353 and 58555-59. Note: This may mean that some payers will require a different diagnosis on each procedure code to allow this combination.

In contrast, when the ob-gyn doesn't use a hysteroscope at any time during the session to do the ablation, you should use 58353 for the Novasure procedure.