Ob-Gyn Coding Alert

Question: When billing a LEEP/ECC, should I use code 57522 with 57454?


Ohio Subscriber

Answer: Code 57522 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision) represents the loop electrocautery excision procedure (LEEP), but be sure that the documentation indicates that the ob-gyn removed all of the transformation zone and all or part of the endocervix.

Code 57454 (Colposcopy of the cervix including upper/adjacent vagina; with biopsy[s] of the cervix and endocervical curettage) represents a colposcopy with endocervical curettage (ECC) and cervical biopsy. 

Your first step is to read the report. An ECC is an integral part of the LEEP conization. This means you cannot bill it separately, nor would you report a cervical biopsy when billing for a LEEP conization because part of the specimen will be the cervix.

If your physician used the colposcope, you should bill 57461 (Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix) for the whole procedure. If the ob-gyn did not use a colposcope, 57522 covers the entire procedure.