Ob-Gyn Coding Alert

Question: During a visit to our office, a patient had a diagnostic hysteroscopy. When the ob-gyn removed the scope, he performed a sharp curettage. A repeat hysteroscopy found a polyp, which was removed with forceps. The physician then did a balloon ablation followed by dilation and curettage (D&C). Should I report the balloon ablation and the D&C? West Virginia Subscriber Answer: Because the ob-gyn used the hysteroscope during the same session as the endometrial balloon ablation, you should report 58563 (Hysteroscopy, surgical; with endometrial ablation [e.g., endometrial resection, electrosurgical ablation, thermoablation]). You may be tempted to report 58558 (... with sampling [biopsy] of endometrium and/or polypectomy, with or without D&C) or 58120 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]) in addition to 58563 to recover payment for the D&C. But the national Correct Coding Initiative bundles both 58558 and 58120 into 58563. Therefore, billing these codes together in this situation is inappropriate. The answers for Reader Questions and You Be the Coder were provided by Melanie Witt, RN, CPC, MA, an ob-gyn coding expert based in Fredericksburg, Va.