used when the D&C relates to pregnancy, labor, or the puerperium.

When an
obstetrical D&C
is performed, the coder should refer to codes 59812-59870 and 59160. A D&C may be
per
formed as a diagnostic test and, based on the findings, a more invasive procedure
may be per
formed at the same operative setting. In these cases, the D&C would not be reported
separately.
Attention should be paid to the descriptors that state with or without dilatation
and curettage.

Code 58152 includes the Burch procedure. Code 58340 includes the injection of dye
or
saline for hysterography and is used with radiology codes 74740 and 76831.

To report an abdominal hysterectomy, the coder should refer to codes 58150-58240,

noting
the descriptors carefully. When a total abdominal hysterectomy is performed and the
tubes and!
or ovaries are removed at the same time, only code 58150 is reported. Because some
descrip
tors in this subsection state "with or without removal of tube(s), with or without
removal of
ovary(s)," these procedures are considered inherently bilateral and modifier -50,
Bilateral
Procedure, would not be appended.

For a vaginal hysterectomy, the documentation needs to state whether the procedure
is per
formed via a laparoscope (58550-58554) or is an open procedure (58260-58294), and
whether
the uterus was greater or less than 250 g in size. These codes are considered
inherently bilateral
and modifier -50 should not be used with the hysterectomy codes.

Laparoscopy/Hysteroscopy Procedures

Laparoscopic surgery is performed by placing a viewing scope and other

instrumentation through
the abdominal or pelvic wall through small incisions. The cavity is filled with gas
to allow
viewing of internal structures. Figure 4.26 displays the surgeon performing a
laparoscopic pro-