Wiki Office visit Procedure for Endometrial Adhesion

[dmarshall]

Hi Group,

Need assistance again please:

Attempt was made to break endometrial adhesion via ultrasound guidance. A speculum was placed and Single tooth tenaculum was used to manipulate uterus. Ultrasound was being used abdominally for guidance. Multiple attempts made to pass into endometrium which was unsuccessful. Instruments removed. Silver nitrate and monsels placed on cervix to obtain adequate hemostasis. This was unsuccessful so figure of 8 stitch with 0 vicryl was thrown which controlled bleeding. Patient tolerated well.

Code 58999 or included in E/M?

Thank you!

 

[csperoni]

New one for me!
IF the procedure had been completed, I would use unlisted and compare it to 58559 (hysteroscopy with lysis of intrauterine adhesions).
IF this had been done with a hysteroscope, I would bill 58559-53.
Since neither of those are the case here, I would bill unlisted and compare to 58559 with a reduction (like 70% of 58559 for example).
And also 76998 for ultrasound guidance.
That being said, assuming there is documentation to justify E/M, I wouldn't count someone wrong for billing E/M only. I just don't think it's the MOST accurate option.

 

[dmarshall]

New one for me!
IF the procedure had been completed, I would use unlisted and compare it to 58559 (hysteroscopy with lysis of intrauterine adhesions).
IF this had been done with a hysteroscope, I would bill 58559-53.
Since neither of those are the case here, I would bill unlisted and compare to 58559 with a reduction (like 70% of 58559 for example).
And also 76998 for ultrasound guidance.
That being said, assuming there is documentation to justify E/M, I wouldn't count someone wrong for billing E/M only. I just don't think it's the MOST accurate option.

 

[dmarshall]

I was leaning towards the unlisted code, thank you!