Dear Volleyb13, I've tried coding both and haven't found a payer (or an outside coding auditor, for that matter) who will allow it, even though CCI allows it with a modifier. I've appealed denials but it always comes back as 'unbundling.' I feel like this is something CPT (or whoever) should review. The D+C uses different instrumentation, the surgeon has to apply separate clinical judgement, the D+C uses more time, and the OR has to allocate more resources. All of this SHOULD point to allowing another code with a modifier - but it never works. The D+C is considered part of the code for the hysteroscopy with ablation.
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