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C-Section Ectopic Pregnancy

I’m writing for advice for CPT advice for managing cesarean scar ectopic pregnancy without concurrent intrauterine pregnancy (ICD-10 O00.80). The patient wished to avoid laparoscopy/laparotomy and underwent transcervical balloon therapy which was inflated adjacent to the ectopic (as has been described/published previously) without success. Several days later during the same inpatient admission, she underwent general anesthesia with ultrasound guided installation of potassium chloride and methotrexate directly in to the ectopic pregnancy, which was successful and she was discharged home the following day.

D&C Under Ultrasound Guidance

What are the CPT codes and ICD-10 codes for coding a surgical case for a patient with history of Stage B adenocarcinoma of the cervix s/p trachelectomy with cerclage placement taken to the OR for dilation of lower uterine segment under ultrasound guidance with passage of uterine sound and embryo transfer catheter?

Diagnostic Hysteroscopy

I am hoping you can help. If the doctors do a hysteroscope #58555 in the office with a Endosee Scope, can I still use the same code even though it is in the office?

Excision Ovarian Endometrioma

When a laparoscopic excision of endometriosis and an ovarian excision of endometrioma with bilateral ureterolysis is performed, what CPT codes is reported?  Can we also bill  separately for the bilateral ureterolysis if the ureterolysis was done from pelvic brim to uterine artery and include retroperitoneal fibrosis which endometriosis patients typically have? 

Hysteroscopic Tubal Cannulation Under Laparoscopic Guidance

How can one code for hysteroscopic transcervical fallopian tube cannulation under laparoscopic guidance? I know the code for the cannulation is 58345. Are there additional codes for the hysteroscopy and the laparoscopy.  Are any modifiers required?

Hysteroscopy Polyp Suspected

What ICD-10 code do you use if a diagnostic hysteroscopy is performed for the preoperative diagnosis of uterine polyp but the postoperative diagnosis is normal uterine cavity?

Hysteroscopy Recurrent Implantation Failure

What is the appropriate ICD-10 code for recurrent implantation failure? The provider performed a diagnostic hysteroscopy for a patient with recurrent implantation failure.

Hysteroscopy Resection of Retained Products of Conception

What CPT is appropriate for a Hysteroscopy Resection of Retained Products of Conception? In the past, I have used the unlisted CPT code 58579, but the claim is always denied for a more specific CPT code. Thank you for your assistance.

IV Fluids During Egg Retrieval

Is it appropriate to bill the insurance company for CPT 96360, Under Hydration Infusion when being used in conjunction with IVF retrieval?  Or, is this IV fluid part of the reimbursement rate for 58970 follicle puncture?  We are a state-registered surgical practice, but we do not bill out facility charges.  We submit for all retrieval and IVF lab coding.

Multiple Laparoscopic Procedures

Is it appropriate to bill for medically indicated, multiple procedures when performing laparoscopies? For example, we occasionally perform fimbrioplasties or large paratubal or ovarian cyst removals (indication infertility) when lasering endometriosis (indication pelvic pain). Can we submit them with the appropriate modifiers (e.g., –51 or –59)? The sites, as well as the indications, are different. There is no requirement by CMS to bundle according to the tables. I do understand that the reimbursements are typically reduced, but that is ok for the purpose of the question.

Office Hysteroscopy Billing

We are doing in office hysteroscopy now. Do you all have a resource that details what all can be billed, or what all is bundled with the 58558 procedure when done in office? For example, IV start, medications, saline.  Regarding IV start, we also had the question as to whether to use 36000 vs 36410 if our Nurse Practitioner is the staff member starting the IV. 


Is there a CPT code for Ovariopexy procedure only, via mini-laparotomy?

Resection Adenomyoma

I have a patient with an adenomyoma of the uterine wall that requires surgical excision and uterine repair. This will be a laparotomy and I don’t see an appropriate code.

Robotically Assisted Tubal Anastomosis

What is the correct CPT code for laparoscopic tubal anastomosis with robotic assistance?   AAPC is stating this procedure is an unlisted code. What is your opinion?   Because the operative report must accompany the surgery claim to the insurance carrier, we also believe the third-party payers will agree with the unlisted code as correct coding.

Surgery Coding

Several years ago, I took the ASRM coding course, and in that course, coding for bilateral neosalpingostomies was coded using only a dx of N70.11 (hydrosalpinx). Yet, for the office-based care of a patient with say, PCOS and infertility, both diagnoses were required for correct coding. Do you agree with either or both of these coding approaches, which seem inconsistent?

Tompkins Metroplasty

Is there a code for Tompkins Metroplasty? Our physician performed this procedure recently, and we are unable to determine the appropriate code to file our claim.

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