Ob-Gyn Coding Alert

Reader Question: Fractional D&C

- Published on Thu, Aug 01, 2002
Question: The physician performed a fractional D&C and removed three polyps. A hysteroscopy was not done. Should I only code for the D&C, or is there a separate code for the polypectomy? Indiana Subscriber Answer: If the polyps were on the uterine lining, you have the option of billing hysteroscopy with D&C, and adding modifier -52 (Reduced services) to 58558 (Hysteroscopy, surgical; with sampling [biopsy] of endometrium and/or polypectomy, with or without D & C). Or, you can bill 58120-22 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]; unusual procedural services) if the removal of the polyps represented significant additional work. The second option is probably the more accurate method of coding, because the first option may result in overpayment if the payer does not recognize modifier -52, which can lead to complications in the event of an audit.  

Get 14-Day Fully-Functional Free Trial of Physician Coder

Get access to all your specialty alerts and archived articles along with some comprehensive tools including:
  • Code Search for CPT®, HCPCS, ICD-9 and ICD-10
  • CCI Edits Checker
  • Part B Fees, MUEs
  • CPT-ICD-9 CrossRef
  • CPT® ↔ ICD-9 ↔ ICD-10 CM Crosswalk
  • LCD/NCD Lookup
  • CMS 1500 Claims Scrubber
  • NDC ↔ CPT/HCPCS CrossReference
First Name: *
Last Name: *
User Name: *
E-mail: *
Phone: *
Choose Speciality*
Please enter the characters shown in box*