Wiki Attempted Ablation aborted/D&C performed

AR2728

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Perryville, MO
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H/S with ablation was attempted x 3 but failed and was aborted. D&C was performed. Is is appropriate to bill 58563-53 along with 58558 or does this become simply 58558? Please advise-below is parial note:

Diagnostic hysteroscopy was performed, ablation balloon unit was tested and primed and then inserted into the uterine cavity to what I believe was the accurate depth of approximately 9 cm. The balloon was filled with approximately 12 cc of D5W and the heating cycle was begun. Shortly after the beginning of the heating cycle, an error message stating that overheating was taking place. The balloon unit was withdrawn from the uterus. The balloon was retested and found to be intact. Ablation was attempted and failed a second time. Sensing perhaps there was a problem within the uterus, I withdrew the balloon a second time and inserted a hysteroscope into the uterine cavity. Careful D&C was performed using a sharp curette. At this time, the uterus sounded to approximately 13 cm and this does exceed the stated limited of 10.5 cm for successful use of the :(ablation device. I did attempt one more time to perform the procedure. Again, I inserted 30 cc of D5W prior to reaching the preferred
pressure in the uterus. At this time, I aborted the entire procedure.
 
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