Ob-Gyn Coding Alert

Question: The doctor performed a transvaginal ultrasound-guided aspiration of ovarian cysts. Should I report this as 58800 and 76948?

Ohio Subscriber

Answer: No. Code 76948 (Ultrasonic guidance for aspiration of ova, imaging supervision and interpretation) refers to "ova," which are unfertilized eggs. Generally, you would use 76948 when the ob-gyn retrieves the eggs under ultrasonic guidance.
 
Instead, the physician aspirated ovarian cysts. You should report this with 58800 (Drainage of ovarian cyst[s], unilateral or bilateral, [separate procedure]; vaginal approach). Most coders also report 76942 (Ultrasonic guidance for needle placement [e.g., biopsy, aspiration, injection, localization device], imaging supervision and interpretation). This would be accurate if the physician used the guidance to place the needle that he used to aspirate the cyst.
 
Alternatively, you could bill 76986 (Ultrasonic guidance, intraoperative) instead of 76942 if the physician performed the actual aspiration under ultrasound guidance. Because either ultrasound procedure could represent accurate coding in this situation, you might want to note that 76986 has a higher relative value than 76942.