How To Use CPT Code 57520

CPT 57520 describes the conization of the cervix procedure, which involves the removal of a portion of the cervix using a scalpel or laser. This article will provide an overview of CPT code 57520, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 57520?

CPT 57520 is used to describe the conization of the cervix procedure, which involves the removal of a portion of the cervix using either a scalpel or laser. This procedure may also include the use of electrical current, known as fulguration, as well as dilation and curettage or repair. It is important to note that CPT code 57520 should not be confused with code 58120, which is used for a similar procedure.

2. Official Description

The official description of CPT code 57520 is: ‘Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser.’ It is important to refer to the official description when reporting this code to ensure accuracy.

3. Procedure

1. The provider prepares the patient for the procedure, administering general anesthesia or a nerve block.
2. The patient is positioned in lithotomy position, and a weighted speculum and retractors are inserted into the vagina to provide access to the cervix.
3. The provider marks the area of excision and injects the cervix with a vasoconstrictor to minimize bleeding.
4. Using a scalpel or laser, the provider makes a circular incision just outside the outer limit of the transformation zone, creating a cone-like excision that includes the exocervix, transformation zone, and some or all of the endocervix.
5. The provider may remove the excised tissue in multiple pieces, using scissors if necessary.
6. Bleeding is controlled using electrocautery, and sutures or a gauze pack may be placed in the cone bed.
7. Endocervical curettage and, if necessary, dilation and curettage of the uterine cavity may be performed.
8. At the end of the procedure, all instruments are removed, and the patient is sent to recovery.

4. Qualifying circumstances

CPT code 57520 is typically performed on patients who require the removal of a portion of the cervix due to certain conditions or diseases. It is important to note that this procedure should only be performed by a qualified healthcare professional. The use of a standardized curriculum is not applicable in this case.

5. When to use CPT code 57520

CPT code 57520 should be used when a provider performs the conization of the cervix procedure using either a scalpel or laser. It is important to ensure that the procedure includes the removal of a portion of the cervix and may involve fulguration, dilation and curettage, or repair. This code should not be used for other procedures or if a different approach is taken.

6. Documentation requirements

When reporting CPT code 57520, the provider must document the following information:

• Patient’s diagnosis and the medical necessity for the conization of the cervix procedure
• Details of the procedure, including the use of a scalpel or laser, fulguration, dilation and curettage, and repair
• Date of the procedure and the duration of the surgery
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up appointments scheduled
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 57520, it is important to ensure that the procedure performed aligns with the official description. This code should not be reported with other codes unless specific circumstances warrant it. It is important to follow the guidelines provided by the payer and ensure accurate documentation to support the claim.

8. Historical information

CPT code 57520 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A provider performs a conization of the cervix using a scalpel to remove a portion of the cervix for a patient with suspected cervical dysplasia.
2. Using a laser, a provider performs a conization of the cervix to remove a portion of the cervix for a patient with early-stage cervical cancer.
3. A patient with recurrent abnormal Pap smears undergoes a conization of the cervix to remove a portion of the cervix for further examination.
4. A provider performs a conization of the cervix with dilation and curettage for a patient with abnormal uterine bleeding and suspected endometrial hyperplasia.
5. Using a scalpel, a provider performs a conization of the cervix to remove a portion of the cervix for a patient with persistent HPV infection.
6. A patient with a history of cervical intraepithelial neoplasia undergoes a conization of the cervix to remove a portion of the cervix for further evaluation.
7. A provider performs a conization of the cervix with repair for a patient with cervical stenosis and recurrent infections.
8. Using a laser, a provider performs a conization of the cervix to remove a portion of the cervix for a patient with adenocarcinoma in situ.