Ob-Gyn Coding Alert

Question: When should I use 57522? Our physicians use 57460 and 57461, but one of our new doctors thinks that we should use 57522.


Colorado Subscriber

Answer: Your first step should be to learn the following loop electrode excision procedure (LEEP) codes.

Code 57522 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision) describes a LEEP conization procedure.

The ob-gyn takes all of the exocervix, all of the transformation zone, and all or part of the endocervix without using a colposcope. This code has only 6.92 relative value units when the ob-gyn performs the procedure in the office. 
 
Code 57460 (Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy[s] of the cervix) describes a LEEP cervical biopsy with the use of a colposcope. The ob-gyn takes the exocervix and all or part of the transformation zone, but not the endocervix. This code has 9.03 RVUs.

Code 57461 (... with loop electrode conization of the cervix) describes a conization of the cervix using a colposcope. This code has 9.96 RVUs.

If the new ob-gyn is not using a colposcope, then 57522 is correct--only if he is doing a conization, not a biopsy. You should code a cervical biopsy using a loop electrode without a colposcope as 57500 (Biopsy, single or multiple, or local excision of lesion, with or without fulguration [separate procedure]).