AHA Coding Clinic® for HCPCS - 2021 Issue 4; Ask the Editor

Hysteroscopic removal of products of conception (POC)

A patient was given misoprostol for a medication abortion. A few days later, it appeared the abortion was complete. However, due to ongoing bleeding and the suspicion for retained products of conception (POC), the decision was made to proceed with surgical management via ultrasound suction dilation and curettage (D&C) with operative hysteroscopy. A speculum was placed in the vagina and the anterior lip of the cervix was grasped with a tenaculum. Under ultrasound guidance, the uterus was dilated and a flexible suction curette was utilized followed by sharp curettage. A nodule of calcified material consistent with residual POC in the right fundal area was visualized in the ultrasound leading to the decision to proceed with hysteroscopy. The hysteroscope was inserted and the nodule was detached from the endometrium and evacuated from the uterus. When retained POC are treated surgically with hysteroscopy, is it appropriate to report CPT code 59812 or 58558? ...

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