How To Use CPT Code 57522

CPT 57522 refers to the conization of the cervix using a loop electrode excision, which may also include dilation and curettage or repair. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 57522.

1. What is CPT 57522?

CPT 57522 is a medical procedure code that describes the conization of the cervix using a loop electrode excision. This procedure may also include dilation and curettage or repair. Conization is a surgical procedure used to remove a cone-shaped piece of tissue from the cervix, which is then examined for the presence of abnormal cells. This procedure is typically performed to diagnose or treat cervical dysplasia or early-stage cervical cancer.

2. 57522 CPT code description

The official description of CPT code 57522 is: “Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; loop electrode excision.”

3. Procedure

The 57522 procedure involves the following steps:

1. The patient is placed in the lithotomy position.
2. The physician determines the size of the lesion and places a grounding pad.
3. A Teflon-coated speculum is hooked up to suction.
4. The cervix is injected with lidocaine and a vasoconstrictor to minimize bleeding in several places.
5. An appropriately sized loop electrode is used to ensure excision of the lesion on the exocervix with adequate margins.
6. A second loop is used to remove the transformation zone and the involved portion of the endocervix.
7. Bleeding is controlled with electrocautery and Monsel’s solution.
8. Endocervical curettage is performed, and the physician may elect to perform dilation and curettage of the uterine cavity, as well.
9. All instruments are removed, and the patient is sent to recovery.

4. Qualifying circumstances

Patients eligible to receive CPT code 57522 services are those who have been diagnosed with cervical dysplasia or early-stage cervical cancer. This procedure may also be performed for patients with abnormal cervical screening results, such as a positive Pap smear or positive human papillomavirus (HPV) test. Additionally, CPT 57522 may be used for patients with recurrent cervical dysplasia or persistent abnormal cervical screening results despite previous treatment.

5. When to use CPT code 57522

It is appropriate to bill the 57522 CPT code when a physician performs a conization of the cervix using a loop electrode excision, with or without dilation and curettage or repair. This code should be used for patients who meet the qualifying circumstances mentioned above, such as those with cervical dysplasia, early-stage cervical cancer, or abnormal cervical screening results.

6. Documentation requirements

To support a claim for CPT 57522, the following information should be documented in the patient’s medical record:

• Indication for the procedure, such as cervical dysplasia, early-stage cervical cancer, or abnormal cervical screening results
• Details of the procedure performed, including the use of a loop electrode, dilation and curettage, or repair
• Size and location of the lesion
• Results of endocervical curettage, if performed
• Any complications encountered during the procedure
• Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT code 57522, it is essential to follow the appropriate billing guidelines and rules. These may include:

• Ensuring that the patient meets the qualifying circumstances for the procedure
• Documenting the necessary information in the patient’s medical record to support the claim
• Using the correct CPT code modifiers, if applicable
• Submitting the claim with the appropriate diagnosis codes that justify the medical necessity of the procedure

8. Historical information

CPT 57522 was added to the Current Procedural Terminology system on January 1, 1995. There have been no updates to the code since its addition.

9. Similar codes to CPT 57522

Five similar codes to CPT 57522 and how they differentiate are:

1. CPT 57520: This code describes a cold knife conization of the cervix, which does not involve the use of a loop electrode.
2. CPT 57460: This code refers to a colposcopy with loop electrode biopsy, which is a less invasive procedure than conization.
3. CPT 57461: This code is for a colposcopy with loop electrode conization, which is a more limited procedure than CPT 57522.
4. CPT 58120: This code describes a dilation and curettage procedure without conization of the cervix.
5. CPT 57420: This code refers to a diagnostic colposcopy without any biopsy or conization.

10. Examples

Here are 10 detailed examples of CPT code 57522 procedures:

1. A 35-year-old woman with a positive HPV test and high-grade cervical dysplasia undergoes a loop electrode excision conization.
2. A 28-year-old woman with persistent abnormal Pap smear results despite previous treatment undergoes a loop electrode excision conization with dilation and curettage.
3. A 40-year-old woman with early-stage cervical cancer undergoes a loop electrode excision conization with repair.
4. A 32-year-old woman with recurrent cervical dysplasia undergoes a loop electrode excision conization and endocervical curettage.
5. A 45-year-old woman with a positive Pap smear and a large cervical lesion undergoes a loop electrode excision conization with dilation and curettage and repair.
6. A 38-year-old woman with a history of abnormal cervical screening results undergoes a loop electrode excision conization with endocervical curettage and repair.
7. A 30-year-old woman with high-grade cervical dysplasia and a positive HPV test undergoes a loop electrode excision conization with dilation and curettage.
8. A 42-year-old woman with early-stage cervical cancer and a large cervical lesion undergoes a loop electrode excision conization with repair and endocervical curettage.
9. A 29-year-old woman with persistent abnormal Pap smear results and a positive HPV test undergoes a loop electrode excision conization with dilation and curettage and repair.
10. A 36-year-old woman with recurrent cervical dysplasia and a history of abnormal cervical screening results undergoes a loop electrode excision conization with endocervical curettage.