What is the appropriate code to report a hysterosal-pingogram performed under ultrasound rather than fluoroscopy? For the catheterization component, a catheter is inserted into the uterus and injection is performed. A second catheter is then lodged in the tubal ostium for injection of contrast directly into the fallopian tube. The catheter is advanced no further. Is this code 58340 or 58345 ? CPT code 58340 seems understated since a catheter must be maneuvered to the tubal os, but code 58345 seems overstated since the fallopian tube is not recannulized. For the radiologic component, the contrast is echogenic and followed on ultrasound (typically transabdominal). CPT code 76831 is for ultrasound but seems limited to the uterus, not the fallopian tubes. CPT code 74740 is specifically for hysterosalpingography but it is not clear whether it is restricted to fluoroscopy or it can also be reported for ultrasound. Answer: The appropriate codes to report are CPT code 58340 , Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography, and CPT code 76831 , Saline infusion sonohysterography (SIS), including color flow Doppler, when performed. Physicians now perform in vitro fertilization (IVF) and bypass tubal obstructive disease procedures in infertility management, making the combination of CPT code 58345 , Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography, and CPT code 74742 , Transcervical catheterization of fallopian tube, radiological supervision and interpretation, now rarely performed (originally performed under fluoroscopy). ...
Subscribe or sign in to view the full article.
Article Overview
This premium article reviews a coding question involving hysterosalpingography performed under ultrasound rather than fluoroscopy. It is aimed at coding professionals and clinicians working with infertility, gynecologic imaging, and radiology supervision/interpreting services. The article discusses the relevant CPT options, compares procedure components, and addresses how the imaging method relates to the reported codes.
Why This Topic Matters
Correctly reporting imaging-guided reproductive tract procedures affects claim accuracy, documentation alignment, and code selection in infertility and gynecologic practice settings. The article helps readers understand the scope of the available CPT choices discussed for this scenario.
Article Sections
-
Question about hysterosalpingography under ultrasound
Introduces the procedural scenario and the coding question being asked. It frames the catheterization and imaging components involved in the service.
-
Discussion of CPT options
Reviews the CPT options referenced in relation to the procedure components and imaging approach. The section contrasts the cited codes in the context of the service described.
-
Answer
Presents the article’s coding-focused response and the related CPT references. It also notes the broader procedural context in infertility management.
What You Will Learn
- How the article frames the coding question for a hysterosalpingography service performed with ultrasound
- Which broad CPT categories are discussed for catheterization and imaging components
- How the article situates the procedure within infertility-related practice
- What types of coding issues arise when imaging guidance differs from fluoroscopy
Who Should Read This
- Medical coders
- Coding auditors
- Radiology coding specialists
- Gynecology and infertility practice staff
- Physicians documenting reproductive tract imaging procedures
Codes Discussed
Subscribe or sign in to view the full article.
Quick, Current, Complete - www.findacode.com