Ob-Gyn Coding Alert

Question: What is the difference between the 57522 and 57461 conization of cervix excision? Also, what is the difference between the biopsy of the cervix endoscopy codes 57500 and 57520?

California Subscriber

Answer: Codes 57522 (Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision) and 57461 (Colposcopy of the cervix including upper/adjacent vagina; with loop electrode conization of the cervix) are identical procedures except in one instance -- code 57461 includes colposcopy.

Code 57520 (Conization of cervix, with or without fulguration, with or without dilation and curettage ...) is a conization of the cervix just like 57522 but uses the laser or cold knife to do the procedure. Code 57500 (Biopsy of cervix, single or multiple, or local excision of lesion, with or without fulguration [separate procedure]) is simply a biopsy of the cervix by any method.

Watch out: A conization is not a biopsy. A conization removes all of the endocervix, all of the transformation zone, and part or all of the endocervix.

-- The answers for You Be the Coder and Reader Questions provided by Melanie Witt, RN, CPC, COBGC, MA, an ob-gyn coding expert based in Guadalupita, N.M.