Ob-Gyn Coding Alert

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.

Question: The patient was diagnosed with endometriosis of the right endometrioma, fibroid uterus. The physician performed a diagnostic hysteroscopy and laser ablation of endometrial implants through the laparoscope and a chromotubation. He also removed two subserosal fibroids on the surface of the uterus (via laparoscope) and then used the laser to remove some other smaller fibroids. There were no adhesions described although the ovary was stuck to one of the endometrial implants. How would I code this?

Georgia Subscriber


Answer: The coding for this surgery is as follows:

58551 laparoscopic removal of fibroids

58662-51 laparoscopic removal of endometrial implants

58555-51 (and maybe -59 if the payer bundles this with laparoscopy) diagnostic hysteroscopy

58350-51 chromotubation.

The chromotubation will generally be paid if it was not done to check the surgeons work, and in this case it appears it was done to see if there was any tubal blockage, so would be considered diagnostic and payable.