Wiki Hysteroscopy dilemma


New Baltimore, MI
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I have a question when a patient is having a hysteroscopic sterlization (58565), D&C and a ThermaChoice ablation. Documentation states Essure sterlization were done then the hysteroscope was removed. Then the D&C and TheraChoice ablation was done. It never states that the scope was reinserted for viewing. I am being told that 58563 should be coded as the scope was used for the other procedure but it clearly states the scope was removed. They reference the CPT Assistant but I still am not getting clear enough verification. Please help.

Here is the last portion of the report:
(Essure procedure performed on both sides), again pictures were taken. Excellent hemostasis was noted. The hysteroscope was then removed. We then proceeded with the sharp curettage. A curette was inserted through the patient's cervix into the uterine cavity. Sharp curettage was performed until a gritty texture was noted circumferentially. The specimens were sent to the Dept of Path. Next, the ThermaChoice ablation was performed. The ThermaChoice ablation catheter was primed with D5W solution. THe catheter was primed and then inserted throught the patient's cervix into the uterine cavity. THe balloon was insufflated using D5W solution and after the eight minute ablation cycle was complete, the D5W solution was withdrawn and the catheter was removed. THe patient tolerated this portion of the procedure without difficulty.

I think 58565 and 58353 are more suitable .