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While some of specialties performing these consultative services may be included in the list of specialties used in steps 2 and 3 of our claims-based assignment methodology, when these specialties furnish the services described by CPT codes 99456, 99457, 99448, 99449, and 99451, they are furnishing these services in a consultative role at the request of the patient's treating/requesting physician or other qualified health care professional, not in a primary care role

They work on different biological layers, which is why they are often combined rather than used as alternatives

Sherman BL, Mills DS

The value of excision of deeply infiltrating endometriosis solely to improve pregnancy is unclear and may adverse affect fertility