Exam with IUD Placement?

dimplez

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Is it appropriate to report CPT 57410 and 58300 when done in the OR? NCCI edits do not bundle, but the chapters state:

1. When a pelvic examination is performed in conjunction with a gynecologic procedure, either as a necessary part of the procedure or as a confirmatory examination, the pelvic examination is not separately reportable. A diagnostic pelvic examination may be performed for the purpose of deciding to perform a procedure. This examination is included in the E&M service at the time the decision to perform the procedure is made.

3. Pelvic examination under anesthesia (CPT code 57410) is included in all major and most minor gynecological procedures and is not separately reportable. This procedure represents routine evaluation of the surgical field.
Source: https://www.cms.gov/files/document/chapter7cptcodes50000-59999final11.pdf

Beyond the above, I have nothing else to support NOT reporting CPT 57410? Does anyone else?
THX
 

nielynco

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Is it appropriate to report CPT 57410 and 58300 when done in the OR? NCCI edits do not bundle, but the chapters state:

1. When a pelvic examination is performed in conjunction with a gynecologic procedure, either as a necessary part of the procedure or as a confirmatory examination, the pelvic examination is not separately reportable. A diagnostic pelvic examination may be performed for the purpose of deciding to perform a procedure. This examination is included in the E&M service at the time the decision to perform the procedure is made.

3. Pelvic examination under anesthesia (CPT code 57410) is included in all major and most minor gynecological procedures and is not separately reportable. This procedure represents routine evaluation of the surgical field.
Source: https://www.cms.gov/files/document/chapter7cptcodes50000-59999final11.pdf

Beyond the above, I have nothing else to support NOT reporting CPT 57410? Does anyone else?
THX
Your information is quite correct. The reason there is no NCCI bundling edit for 57410 and 58300 is that Medicare does not cover 58300 so they never developed an edit for a non-covered service. You should not report 57410 with 58300.
 
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