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Cpt for Hystersalpingography

preserene

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CPT for hysterosalpingography:
Hysterosalpingography involves two components-First portion by OBGYN physician who introduces the catheter and injects/introduces the saline/contrast material through the cervix- fallopian tube.
The second portion- the pictures taken are to be interpreted by the radiologist for the diagnosisof patency/blocakage(ie the interpretation and report.
The first coponent coding 58340.(Surgery Section/gyn)
the second one coding.....74740. (Radiology Section)

so for my openion 58340 and 74740 are the appropriate

The code 58350 does not arise here at all, because it is for chromotubation which is a open surgical procedure at theatre settings with a dye for confirming about the patency/blockage and a therapeutic procedure.

The code 76831 also do not apply here because it is for SONOHYSTEROGRAPHY.
 

preserene

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To answer with regards to code 58345, it is also not applicable for regular and conventional Hysterosalpingography wherein the catheter is introduced transcervical just to pass through the internal OS into the uterine cavity but not reaching the fallopian tube and and there is no class by "ANY MEHTOD' in Hysterosalpingography. Hence the code number 58345 not applicable for hysterosalpingography alone.
 
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preserene

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Hysterosalpingography/Hysterosonography/UltrasoundTransvaginal: Coding-

Hysterosalpingography/Hysterosonography/UltrasoundTransvaginal Coding:
When the Physician did Hysterosalpingograhy and is the only documented procedure, the reports 58340 and74740 are the appropriate coding as far my knowledge goes.
When Hysterosonography alone done we cannot report it as Hysterosalphingography and vicevera; so also US Vaginal-(76831)gyn.
Ultrasound transvaginal is not a Hysterosonography but in conjunction with hysterosonography can improve diagnostic accuracy,diagnostic certainity.; but as a diagnostic imaging procedure that serves as the baseline for a hysterosonographic examination. Transvaginal ultrasonography in conjunction with hysterosonography can improve diagnostic accuracy,
Ultrasonography- a technique for Endometrial Evaluation and find uterine abnormalities
Hysterosonography, involves introduction of probe of transcervcial sonography showing the internal structure of the uterus, assess the thickness and possible abnormalities of the patient's endometrium. The doctor then inserts a catheter into the uterus and injects sterile saline fluid while ultrasound imaging is recorded on film or videotape. The procedure takes about 10 to 15 minutes, usually done by ObGYN physician alone-both procedure and reporting.
In Hysterosalphingography, the infra structure, procedure, purpose and the role are completely different from Sonohysterography. Its main stay is tubal pathology( tubal abnormalities and patency), of course gross uterine abnormlities can also be visualized and x-rayed as a concomitant finding, but it is not as specific as the hysterosonograghy does for uterine pathology. It necessarily involves two Physicians- Physician Surgical(Gynecologist), and Physician Radiological(Radiologist) for interpretation and reporting.
The question and choice of when to do/ what to do/or in conjunction with or not, is the doctor's choice of performance and documentation.
Though these procedures differ in infrastructure, procedure and role, they complement each other for the final outcome of decision-making.
Yet, so long as they are not bundled up in cording for reporting, how can we compromise the code description of one to the other?
I would politely like to clear this doubt with Lisa Curtis how any one of these 76831, 76830-59” could be be reported for this case -only Hysterosalpingography documented?.
{It is fine they pre-assess the uterus,Cx,and to rule out pregnancy;it is a prerequisit. Or they own thier own US. Does it modify/determine this one?}

Thank you in advance, Lis Curtis.Thank you very much for theTime.
 
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