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58563 and 58120

  1. Question 58563 and 58120
    Medical Coding Books
    My physician performed a hysteroscopy, there was a strip of endometrium that was sent for examination, she then removed the hysperoscope, did a D&C and ablation, then reinserted the hysteroscope and performed the hysteroscopy. I did a search of old posts and saw one coder coded 58563-58 and 58120. My encoder pro allows me to code this as 58563-58 and 58120-51-59. Is this correct coding or is 58120 included in 58563, and should I just code this as 58563? The surgery occurred in 12/10. I couldn't find the CPT 2003 Assistant to reference. Any help would be greatly appreciated.

  2. #2
    I work for an ASC and we perform those ablations all of the time. I only approve of coding 58563 because 58120 is included in what it takes to do the 58563. Additionally, there is a CCI edit for using 58120 with 58563. A lot of payers will pay for both if you bill them (I have one practice that insists on using both codes together) but that doesn't make it right if your documentation does not justify both. Hope this helps

  3. Default
    Yes, thank you so much for your reply. Yes, it helped a lot! I am so glad to have this forum.

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