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Ob-Gyn Coding Alert

Reader Questions:

Stop Looking for an Nabothian Cyst Code

Published on Mon Sep 27, 2004

Question: One of my ob-gyns performed an incision and drainage (I&D) of a Nabothian cyst on the cervix area. I am having trouble coding the procedure for this. Is there a specific CPT code I should use?

Michigan Subscriber Answer: No code exists for this type of cyst. Carriers won't reimburse for this cyst because carriers consider it to be a minor condition that does not require any significant work to remove or incise and is therefore just part of the E/M service.
 
And many payers do not reimburse ob-gyns for removing this type of cyst without documentation showing significant work. These cysts are very common, and most patients are unaware they have them until their ob-gyn performs a Pap smear and the results point it out. The best advice is to roll it into the E/M service. If your ob-gyn insists on billing, you should use unlisted-procedure code 58999 (Unlisted procedure, female genital system [nonobstetrical]).
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