LKester
New
Can you bill 58100 and hysteroscopy ablation (58563) done on the same day ? 58100 was done prior to the ablation.
Thank you!
Thank you!
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Wiki 58100 and 58563
- Thread starter LKester
- Start date
nsteinhauser
Expert
Were they both done at the same operative session? If yes, I would think the 58100 is considered bundled into the "larger" procedure. A modifier is allowed to break the NCCI edit between 58100 and 58563 but I wouldn't separately code for it because 58100 is listed as a "separate procedure."
LKester
New
Thank you Yes both were done at the same operative session.
nielynco
Expert
Per the CPT Assistant Q&A in September 2015:
Q: Would it be appropriate to report code 58563, Hysteroscopy, surgical; with endometrial ablation (eg, endometrial resection, electrosurgical ablation, thermoablation), when the dilation and curettage (D&C)/hysteroscopy and the endometrial ablation procedures are not done simultaneously?
Answer: Yes. It would be appropriate to report code 58563 because this code encompasses the D&C/hysteroscopy
work as well as the ablation, and the work for the D&C and hysteroscopy do not have to be done simultaneously.
This clearly indicates that the D&C is included whether done simultaneously or not so you should not bill 58100 with 58563.