Ob-Gyn Coding Alert

"Question: The ob-gyn used a colposcope and loop electrocautery excisional procedure (LEEP) to do a wide excision on the vulva. Do I use 57460? I thought the ob-gyn had to perform on the cervix to use this code. Kentucky Subscriber Answer: The correct code is 56820 (Colposcopy of the vulva). Code 57460 (Colposcopy of the cervix including upper/adjacent vagina; with loop electrode biopsy[s] of the cervix) means the ob-gyn did a colposcopy of the cervix. For the excision of a lesion by any means, you should look to an integumentary code (based on size and whether malignant or benign). If this was more a biopsy than an excision, you instead would report 56821 (Colposcopy of the vulva; with biopsy[s]). Use of the loop to do a biopsy does not affect the code you use except when colposcopy of the cervix is involved."