If your doctor did a hysteroscopy with the ablation then I would use 58563. If not then I would use 58353. You can bill the paracervical block. Some insurance companies will pay for it and some won't so it just depends on the payer. 58565 is correct for the essure. I would do 58565-59 then 58563 or 58353 and 64435 with a 51 mod.
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