But how is the coder to know which code to use with the new techniques and what other services can be billed at the time of the procedure? "To begin identify the various types of services provided at the time of the endometrial ablation to see if any can be coded in addition to the procedure " says Melanie Witt RN CPC MA an independent coding consultant and educator based in Fredericksburg Va. All of the new techniques for endometrial ablation have cervical dilation in common. Because this is an integral part of the procedure you normally would not code it separately if performed at the time of the procedure. Some physicians however may elect to prepare the cervix in advance using a cervical dilator. You can report this procedure separately using 59200 (Insertion of cervical dilator [e.g. laminaria prostaglandin] [separate procedure]).
"Because this is a CPT 'separate procedure ' if the ob-gyn performed the cervical dilation on the same date as the ablation but earlier in the day and the physician has met the criteria for using this modifier modifier -59 (Distinct procedural service) should be added " Witt says. If the insertion took place the day before surgery you would not need to add a modifier. "Also note that because 59200 has a zero-day global period you would not need a modifier for the endometrial ablation code performed the next day either " she adds. The new methods for performing endometrial [...]