What is the CPT code 58563?
Background
| Information in the [brackets] below has been added for clarification purposes. Codes requiring a 7th character are represented by “+”: | |
|---|---|
| Code | Code Description |
| 58563 | Hysteroscopy, surgical; with endometrial ablation (e.g., endometrial resection, electrosurgical ablation, thermoablation) |
Can 58558 and 58353 be billed together?
Expert. The correct CPT for the Novasure Ablation is 58353 (this is not a “hysteroscopic” procedure). My CCI edits indicate that 58558 (Hystero w/ D&C) cannot be billed with 58353 (even if an appropriate modifier is present).
What is the global period for 58558?
Is there a global period of “0” days, “10” days or “90” days for 58555 or 58558? Both codes have “0” day global periods.
Does 58561 include D&C?
Code 58120 (Dilation and curettage, diagnostic and/or therapeutic [nonobstetrical]) is not bundled with code 58561 under the National Correct Coding Initiative (NCCI). But to avoid denial you must establish medical justification for doing the curettage by indicating a diagnosis other than submucous fibroid (218.0).
Is endometrial ablation considered surgery?
Endometrial ablation is a procedure to remove a thin layer of tissue (endometrium) that lines the uterus. It is done to stop or reduce heavy menstrual bleeding. But it is only done on women who do not plan to have any children in the future. The procedure is not surgery, so you will not have any cut (incision).
What is NovaSure endometrial ablation?
What is NovaSure? NovaSure Endometrial Ablation is a one-time, 5-minute procedure that gently removes the lining of the uterus – the part that causes the bleeding. The NovaSure procedure can reduce or stop bleeding altogether. It’s less invasive than hysterectomy, and avoids the potential side effects of hormones.
What is a global CPT code?
The global package for a major procedure begins one day before the procedure or service and includes the day of service plus the 90 days that follow (a total of 92 days). You can find global periods for all CPT® codes using AAPC Coder or other encoder software, or in the CMS Physician Fee Schedule Relative Value File.
What is the global period for CPT code 11042?
The payment for 11043 is almost five times more than the payment for 11042 (debridement of skin and subcutaneous tissue only) when performed in a hospital or ambulatory surgery center and is based on 45 minutes of intraservice physician work and has a 10 day global period (payment for 11042 is based on 15 minutes of …
What does 58563 mean?
The 58563 is a surgical hysteroscopy with endometrial ablation and is worth 9.37 RVUs (when performed at a non-office setting). It makes sense to me that if the 58558 includes D&C, then so would the 58563. That could be flawed logic, but that’s all I’ve got…
What is the CPT code for global period?
It is important to note that CMS changed the global period from a 090 day global period to a 000 day global period for CPT code 30140. This change in in global period from 090 to 000 will allow providers to bill for follow-up care performed.
What is the CPT code for an annual physical exam?
A: The CPT code for the annual routine physical exam for Medicare is 99387 (preventative medicine E/M new patient age 65 and older) or 99397 (preventative medicine E/M established patient age 65 or older). This is the same code for all insurance companies.
What is the CPT code for endometrial biopsy?
CPT has two codes for endometrial biopsy: 58100* (Endometrial sampling [biopsy] with or without endocervical sampling [biopsy] without cervical dilation any method [separate procedure]) and 58558 ( Hysteroscopy surgical; with sampling [biopsy] of endometrium and/or polypectomy with or without D & C).
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