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Hysteroscopy – 58558 Situation

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, surgical; with sampling of endometrium, however, the 58558 does not capture sampling of tissue from the fallopian tubes.

The question is: what if you had an accessory that could be used with the Hysteroscope to obtain samples of tissue from the fallopian tubes? Can you bill a miscellaneous code for the accessory, i.e. A4649, that was used to obtain the sample?

My concern is that the 58558 does not capture sampling of tissue from the fallopian tubes and I am not finding a code that captures sampling 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 for any help you can provide –
Kris

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