Radiology Coding Alert

Question: How should I code a hysterosalpingogram (HSG) performed with obstetrics and gynecology for an infertile patient? The radiologist found no evidence of fallopian tube occlusion, stating, "free spillage from both fallopian tubes."Maryland SubscriberAnswer: The answer depends on the precise services your radiologist provides.For the radiologist's services, the appropriate code is typically 74740 (Hysterosalpingography, radiological supervision and interpretation).The obstetrician/gynecologist will most likely perform and report 58340 (Catheterization and introduction of saline or contrast material for saline infusion sonohysterography [SIS] or hysterosalpingography).Note: If a radiologist performs both services, you may report both codes, according to AMA's CPT Assistant (July 1999).Watch modifiers: If the radiologist is not in the room for the procedure and performs only the interpretation, you should report 74740 and append modifier 52 (Reduced services), directs Medicare Claims Processing Manual, chapter 13, section 80.1.And if the patient has the procedure in a hospital or facility setting, append modifier 26 (Professional component), as well.ICD-9: Because the radiologist didn't note any tubal blockage, you should report 628.9 (Infertility, female; of unspecified origin).