This page addresses follow-up questions and additional information pertinent to our webinar
GYN Anatomy and Approaches.
** The coding information and guidance are valid at the time of publishing. Learners are encouraged to research
subsequent official guidance in the areas associated with the topic as they can change rapidly.
Q: The code descriptor for 58660 indicates laparoscopy with lysis of adhesions, then in parentheses calls out salpingolysis and ovariolysis specifically. Is this code used only for adhesiolysis of the ovaries and fallopian tubes or can it be used for adhesions located anywhere in the abdominal or pelvic cavity?
A: Per CPT, while code 58660, Laparoscopy, surgical; with lysis of adhesions (salpingolysis, ovariolysis) does involve endoscopic inspection and evaluation of the abdomen and pelvis, the code represents adhesion lysis of uterine adnexal (i.e., fallopian tubes, ovaries functionally and structurally adjacent to the uterus). CPT Assistant 2011, December
Q: What code is used to for endometrial ablation when the ablation is performed by Radiofrequency? It’s mentioned as a method, but not given as an example in any code descriptors.
A: Radiofrequency energy is used to destroy uterine lining by a special probe device. NovaSure is a common term seen for radiofrequency ablation. During this procedure, a hysteroscope is utilized to assist in the ablation. This method of ablation is represented by 58563.
Q: Can code 58558, hysteroscopy with or without dilation and curettage be an option selected to remove pregnancy tissue if it occurred fairly early on in the first trimester?
A: As of now, the concept of using code 58558 to remove retained products of conception via hysteroscope has not been addressed, so we would not recommend it. We would recommend moving to 59820. ACOG coding committee has recommended potentially using 58558 if the procedure has been done more than 90 days after the initial surgery. The cervix is dilated and a hysteroscope is placed into the uterus and the tissue is removed from inside via curettage.
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Emily Lomaquahu, CPC, CPMA, CEDC
Senior Coding Quality Auditor & Educator
Emily is a Senior Coding Quality Auditor for Haugen Consulting Group and brings over a decade of experience to the profee team! She began her career as an auditor and with her keen eye for detail, she quickly found it was a perfect fit. Emily thrives in a collaborative environment and enjoys creating high-quality trainings to help providers and coders navigate charts and improve their accuracy. She earned a bachelor’s degree from the University of Colorado, in Denver. Emily specializes in Evaluation and Management (E/M), Primary Care, Anesthesia, Emergency Department, and Neurology, though she says Anesthesia and Neurology are her favorites! She is a Certified Professional Coder (CPC), Certified Professional Medical Auditor (CPMA), and Certified Emergency Department Coder (CEDC).