How To Use CPT Code 58573

CPT 58573 refers to a laparoscopic surgical procedure involving a total hysterectomy for a uterus greater than 250 g, with the removal of tube(s) and/or ovary(s). This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 58573.

1. What is CPT 58573?

CPT 58573 is a medical code used to describe a specific type of laparoscopic surgical procedure that involves the removal of a uterus weighing more than 250 grams, along with the removal of fallopian tube(s) and/or ovary(s). This code is used by healthcare providers to accurately document and bill for this particular procedure.

2. 58573 CPT code description

The official description of CPT code 58573 is: “Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)”

3. Procedure

The 58573 procedure involves the following steps:

  1. The patient is placed in the dorsal lithotomy position, and the abdomen is prepped and draped.
  2. General anesthesia is administered.
  3. The provider enters the abdominal cavity using a Veress needle or an open incision and places a laparoscope.
  4. The abdomen is insufflated with CO2 gas to create a pneumoperitoneum, and the patient is put into the Trendelenburg position.
  5. Small incisions are made around the abdominal area to insert trocars for better visualization and insertion of surgical tools.
  6. If robotic surgery is performed, the robot is docked to the laparoscope.
  7. A combination uterine manipulator-colpotomizer device is placed into the uterus through the cervix for manipulation and guidance during the procedure.
  8. The provider identifies the course of the ureters and dissects them free to avoid damage during surgery.
  9. Infundibulopelvic ligaments are desiccated using a heated instrument, followed by the veins between the ovary and round ligaments.
  10. The round ligaments are incised, and the uterus is dissected from the anterior and posterior broad ligament.
  11. The infundibulopelvic ligaments are incised with a scalpel, and the bladder is mobilized off the lower uterine segment.
  12. The uterine arteries are stripped from the surrounding tissue and ligated.
  13. The cardinal and uterosacral ligaments are incised and clamped.
  14. A circular incision is made around the anterior and posterior vagina with the colpotomizer in place.
  15. The uterus is morcellated to reduce its size and removed through the vagina or trocar ports.
  16. The vaginal cuff is sutured through the laparoscope, and the uterosacral tissues are folded and shortened to prevent enterocele formation.
  17. The provider confirms no bleeding, deflates the abdomen, and removes all instruments and trocars.
  18. All trocar sites are closed with sutures at the level of both the fascia and the skin.

4. Qualifying circumstances

Patients eligible to receive CPT code 58573 services are those who require a total hysterectomy due to medical conditions such as uterine fibroids, endometriosis, or cancer, and have a uterus weighing more than 250 grams. The decision to perform this procedure is based on the patient’s medical history, symptoms, and the results of diagnostic tests and imaging studies.

5. When to use CPT code 58573

CPT code 58573 should be used when a healthcare provider performs a laparoscopic surgical procedure involving a total hysterectomy for a uterus greater than 250 g, with the removal of tube(s) and/or ovary(s). This code is appropriate for billing purposes when all connections are severed through the scope, and the uterus is removed through the scope by cutting it into small pieces or through the vaginal canal, with the vaginal cuff sewn from above through the laparoscope.

6. Documentation requirements

To support a claim for CPT 58573, the following information should be documented:

  • Patient’s medical history and reason for the procedure
  • Diagnostic tests and imaging studies performed
  • Details of the surgical procedure, including the steps performed, instruments used, and any complications encountered
  • Weight of the uterus and the removal of tube(s) and/or ovary(s)
  • Postoperative care and follow-up instructions

7. Billing guidelines

When billing for CPT code 58573, it is essential to follow the specific guidelines and rules set by the payer. Some tips for billing this code include:

  • Ensure accurate documentation of the procedure and its necessity
  • Do not report CPT 58573 in conjunction with codes 49320, 57000, 57180, 57410, 58140-58146, 58150, 58545, 58546, 58561, 58661, 58670, and 58671
  • Verify payer-specific requirements and guidelines for billing this code

8. Historical information

CPT 58573 was added to the Current Procedural Terminology system on January 1, 2008. There have been no updates to the code since its addition.

9. Similar codes to CPT 58573

Five similar codes to CPT 58573 and how they differ are:

  • CPT 58570: Laparoscopic hysterectomy for a uterus weighing 250 g or less, with removal of tube(s) and/or ovary(s)
  • CPT 58571: Laparoscopic hysterectomy for a uterus weighing 250 g or less, without removal of tube(s) and/or ovary(s)
  • CPT 58572: Laparoscopic hysterectomy for a uterus weighing more than 250 g, without removal of tube(s) and/or ovary(s)
  • CPT 58561: Laparoscopic hysterectomy with removal of tube(s) and/or ovary(s) and sampling of pelvic and/or para-aortic lymph nodes
  • CPT 58554: Laparoscopic supracervical hysterectomy for a uterus weighing more than 250 g, with removal of tube(s) and/or ovary(s)

10. Examples

Here are 10 detailed examples of CPT code 58573 procedures:

  1. A 45-year-old woman with a large uterine fibroid causing heavy menstrual bleeding undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes and ovaries.
  2. A 50-year-old woman with endometrial cancer and a uterus weighing 300 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes.
  3. A 38-year-old woman with severe endometriosis and a uterus weighing 275 g undergoes a laparoscopic total hysterectomy with removal of both ovaries.
  4. A 47-year-old woman with a history of multiple large uterine fibroids and a uterus weighing 350 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes and ovaries.
  5. A 52-year-old woman with a large uterine fibroid causing pelvic pain and a uterus weighing 280 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes.
  6. A 41-year-old woman with a history of severe endometriosis and a uterus weighing 325 g undergoes a laparoscopic total hysterectomy with removal of both ovaries.
  7. A 48-year-old woman with a large uterine fibroid causing urinary incontinence and a uterus weighing 290 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes and ovaries.
  8. A 53-year-old woman with a history of multiple large uterine fibroids and a uterus weighing 310 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes.
  9. A 40-year-old woman with severe endometriosis and a uterus weighing 260 g undergoes a laparoscopic total hysterectomy with removal of both ovaries and fallopian tubes.
  10. A 49-year-old woman with a large uterine fibroid causing heavy menstrual bleeding and a uterus weighing 320 g undergoes a laparoscopic total hysterectomy with removal of both fallopian tubes and ovaries.

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