Wiki Cervical Polyp Removal

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clovell

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Our OB/Gyn twisted off a cervical polyp with ring forceps and applied silver nitrate and sent for biopsy. Is there a separate procedure charge that accurately describes this service or is it just part of the E&M? The codes I considered all seemed to indicate there was some sort of cutting involved, which did not happen in this case.

Any assistance in coding this would be greatly appreciated!

Thank you!

Connie Lovell
 
There is no code that I am aware of either - I advise phyiscians to consider the time spent and work performed when choosing their E/M code.
 
Why not 57500? Isn't a polyp a lesion? In my Taber's a lesion is a tumor and a polyp is a tumor... Polyps usually form on/in mucousal organs/tissue, and I believe the cervix falls into that category.
 
The "small cut" is what was throwing me. Since the code reads biopsy of cervix OR local excision of lesion, is it appropriate to code based on the "biopsy of cervix" since the polyp was sent for biopsy?
 
I see where everyone is coming from, but I still disagree...the CPT Coding Reference states that "a speculum is inserted into the cervix, a small cut is made, and forceps are used to remove the tissue, bleeding may be stopped by electric current" to me if you are simply using forceps to twist and pull off a polyp you didn't do they same amount of work.
 
clovell said:
The "small cut" is what was throwing me. Since the code reads biopsy of cervix OR local excision of lesion, is it appropriate to code based on the "biopsy of cervix" since the polyp was sent for biopsy?
Click to expand...

I believe it is appropriate. Twisting the polyp off is going still going to create a "cut". I think we are getting hung up on the verbiage.
 
I also still think 57500 is appropriate. If you still disagree, add a -52 and take less payment for less work.
 
Keep in mind that each CPT code is valued both on physician time and equipment used. In the case of 57500, a cervical biopsy forceps or scalpel would have to be used and the typical time to do the actual removal is 15 minutes. Using ring forceps would not make this the same thing as a biopsy procedure as intended for 57500, whose purpose is to remove cervical tissue from the cervix using a cervical biopsy forceps (or a scalpel to cut off tissue). Sending the cyst for a biopsy after it is twisted off its stalk, is in my mind not the same thing as intended when 57500 was added to CPT.
 
IF there was a hysteroscope used to find the mass and the then mass was grasped with a single-toothed tenaculum and loop method was performed, would I code both 58555 and 57500? I have received a denial for using both codes as not separately payable. please advise
 
haygoodcas@bayviewphysicians.com said:
IF there was a hysteroscope used to find the mass and the then mass was grasped with a single-toothed tenaculum and loop method was performed, would I code both 58555 and 57500? I have received a denial for using both codes as not separately payable. please advise
Click to expand...
A hysteroscope examines the uterus, not the cervix. A cervix would more likely be examined with a colposcope.
Was the polyp of the cervix or of the uterus?
If the physician examined the uterus with a hysteroscope and removed a polyp of the uterus, there is one single code to describe this work.
58558 Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C
The codes you provided, 58555, 57500 are not NCCI edits, but do both have the separate procedure as part of the description. The clinical scenario seems unlikely, but if that is what was performed, I would appeal with records and ensure an appropriate diagnosis is linked to each CPT.
 
Thank you , I appealed with notes, Dr actually only used the Hysteroscope to visualize cervical mass. The mass was found when resecting the hysteroscope from the uterus. The hysteroscope was removed then the mass was removed by Loop electrode method and not through the hysteroscope. The mass was actually on the cervix
 
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