cedure on the female reproductive organ .

It should be noted that a

surgicallaparoscopy always
includes a diagnostic laparoscopy. When a procedure starts with a diagnostic
laparoscopy and
then a surgical procedure i performed through the laparo cope, only the
surgicallaparoscopic
code is assigned. Code 49320 should be as igned to report a diagnostic laparo copy
when per
formed as a separate procedure. Code 58555 should be used to report diagnostic
hysteroscopy
as a separate procedure.

Laparoscopic hysterectomies are coded to 58570-58573, ba ed on whether the tube(s)

and
ovary(s) were also removed, the size of the uteru and whether the resection was
performed for
malignancy and involves an omentectomy. A laparoscopic hysterectomy involves
disconnec
tion of all the organs using the laparoscope, including the cervix. The organ can
be removed
either through the use of an Endocatch bag or removed through the vaginal opening
created
as the cervix was dissected. In contrast, a laparoscopy, surgical with vaginal
hysterectomy,
codes 58550-58554, involve the di connection of the uteru , tube(s) and ovary(s)
using the
Japaro cope and the dis ection of the cervix through the vaginal canal. In this
procedure, all
the organs are removed through the vagina. This is also called a laparoscopic-
assisted vaginal
hysterectomy (ACOG 2007). Figure 4.27 displays the laparoscopic-assisted vaginal
hyster
ectomy procedure.