Ob-Gyn Coding Alert

Question: I’m not sure if I should bill for D&C separately. I’m billing 58662 for main procedure (cystectomy/only cyst was removed).  After the main procedure was completed, the note goes on to say: “The hysteroscope was introduced into the cavity w/ no intracavitary lesions noted. Scope removed and uterine cavity was curetted until a gritty texture was noted. There was a moderate amount of curettings noted. Tenaculum was removed from cervix.” Is this part billable (58120)? The post-op dx’s left endometrioma and menometrorrhagia.

South Carolina Subscriber

Answer: You must bill 58662 (Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method) and 58558 (Hysteroscopy, surgical; with sampling [biopsy] of endometrium and/or polypectomy, with or without D & C). Payers will consider this a hysteroscopic D&C even though he removed the scope to do it.