Hi – I have a unique coding and billing situation regarding CPT code 58558, Hysteroscopy, surgical; with sampling (biopsy) of endometrium and/or polypectomy, with or without D & C.

The 58558 includes the Hysteroscope, but what if you had an accessory for the Hysteroscope that is used during the procedure to obtain samples of tissue from the fallopian tubes? Can you bill a miscellaneous code for the accessory, i.e. A4649? The 58558 does not capture sampling of tissue from the fallopian tubes.

The Hysteroscope is not new technology, but the accessory is, so would it be better to look at applying for a category III code?

Thank you in advance for any help you can provide –
Kris