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Hysteroscopy - 58558 Situation

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Hi - I have a unique coding and billing situation regarding CPT code 58558, Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C.

The 58558 includes the Hysteroscope; what if you had an additional accessory that could be used with the Hysteroscope, can you bill a miscellaneous code for the accessory, i.e. A4649?

The Hysteroscope is not new technology, but if the accessory is new, would it be better to look at applying for a category I or III code?

Thank you for any help you can provide -
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