58562 is correct and the only cpt code I would give. Diagnosis code V25.42 or V25. 40. I do not know if there is a separate code for failed procedure for IUD in 2010; if not this would go for it.
I would not give the open failed procedure code along with the endoscopy code. The endosopic procedure is undertaken for the same purpose and complete in which case 58301 is integrated into it. You could report a E/M code for that and a documentation.
I feel you could give V code to indicate the encounter and a Physician report
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