Basics about hsg test/Hysterosalpingogram Cpt Code 58340

Hysterosalpingogram or hsg scan/test is an x-ray study inside of the uterus and fallopian tubes. During this procedure a dye is injected through the vagina and into the uterus. The dye flows both into uterus and fallopian tubes. Images are obtained using fluoroscopy.  The image helps in finding any abnormality in the uterus or fallopian tubes.

Uterus x ray exam in done especially on women who are having hard time to become pregnant. Hence, this exam also helps in finding any blockage which is preventing the egg moving from the fallopian tube to the uterus. The obstruction can prevent the sperm from joining with the egg and fertilizing it.

We are here to learn Hysterosalpingogram Cpt Code used in interventional radiology coding. This CPT code is used frequently for patient coming with female infertility. Below are the Hysterosalpingogram Cpt Code used for studying uterus and fallopian tubes.

58340– Catheterization and introduction of saline or contrast material for saline infusion sonohysterography (SIS) or hysterosalpingography

76831– Saline infusion sonohysterography (SIS), including color flow doppler, when performed

74740– Hysterosalpingography, radiological supervision and interpretation

The first primary code is always 58340 for Injection procedure coded with secondary Sonohysterography or Hysterosalpingogram Cpt Code. But, the secondary CPT code depends on the either hysterosonography (76831) or hysterosalphingography (74740). Hysterosonography or hsg exam uses ultrasound while hysterosalphingography uses fluoroscopy to take images for study.

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Diagnosis related to Hsg scan Cpt Code 58340

Hysterosalpingogram Cpt Code is always coded with diagnosis causing a blockage in uterus or diagnosis related to female infertility. The other problems which lead to perform hysterosalphingography are problems in uterus like polyps, fibroid, adhesions, abnormal shape or structure etc. So, next time you see a physician performing hysterosalphingography do check to search for these diagnosis in the report. These are the most common diagnosis found along Hysterosalpingogram Cpt Code.

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Difference between Hysterosonography(76831) and Hysterosalpingography(58340)

The most common use of hysterosonography is for evaluation of patients with dysfunctional or postmenopausal bleeding when endometrial abnormalities (eg polyps, hyperplasia, carcinoma) are suspected. Hysterosonography may also be used to evaluate fallopian tube patency and endometrial cavity anatomy for infertility patients.

Hysterosonography entered into widespread use over the past four years. This growth is due in part to the avoidance of the exposure to radiation and iodinated contrast (associated with x-ray hysterosalpingography), anesthesia, and an operative setting (associated with hysteroscopy).

Hysterosonography shares some of the same technical imaging requirements as transvaginal ultrasound, however, unlike transvaginal ultrasound, hystero-sonography requires catheterizing the cervix. The procedure may be performed either by one physician doing both the catheterization and imaging or by two physicians, with one doing the catheterization portion of the procedure and the other physician supervising and interpreting the imaging. In either instance, both an imaging code and a catheterization code would be reported.

The catheterization and injection of saline associated with hysterosonography is very similar to that associated with hysterosalpingography and injection of iodinated contrast media. Therefore, rather than add a new code for the hysterosonography catheterization, CPT code 58340 was editorially revised to accommodate reporting of either procedure.

Medicare Reimbursement rate, cost, price of CPT code 58340

Below are the Medicare Reimbursement rate, cost, price of CPT code 58340 for all MAC & locality/region wise as per the data available.

source link:

https://www.cms.gov/medicare/physician-fee-schedule/search?Y=0&T=0&HT=0&CT=3&H1=58340&M=5

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Do and Don’t Hysterosalpingogram Cpt Code 58340

Never code a Hysterosonograhpy code 76831 when the exam is performed under fluoroscopy i.e. hysterosalphingography 74740.

Do code supervision and interpretation code 74740, which is always performed with Hysterosalphingogram CPT Code.

Do not code hysterosonography 76831 and hysterosalphingogram S&I code 74740 together unless the documentation support.

Codes 74742 and 58345 (Transcervical introduction of fallopian tube catheter for diagnosis and/or re-establishing patency (any method), with or without hysterosalpingography) include diagnostic imaging if performed. As such, do not also assign CPT code 58340 and 74740 when reporting the codes for re-establisment of patency. If performed bilaterally, assign code 58345 x2 and 74742 x2. Modify as directed by local payer.

ICD Codes related to hysterosalphingogram CPT code

N73.6 Female pelvic peritoneal adhesions (postinfective)
N97.1 Female infertility of tubal origin
N97.2 Female infertility of uterine origin
N97.8 Female infertility of other origin
N97.9 Female infertility, unspecified
Z31.41 Encounter for fertility testing

Hope you would have understood how to use Hysterosalphingogram cpt code in IVR procedures. If you would have liked it do share it.