CPT’s manual describes 18 hysterectomy CPT codes ranging from CPT 58150 to CPT 58294. Descriptions and billing guidelines for the CPT codes for hysterectomy can be found below.
CPT codes for hysterectomies can be viewed in the CPT manual’s surgery section The codes are organized according to their elimination method and scope. Due to the diversity of hysterectomy procedures, which can be involved up to 30 different regulations, it is crucial to ensure that you have the correct one before surgery.
The American Medical Association (AMA) administers the CPT 58150 until CPT 58294 for corpus uteri excision procedures. The Corpus uterus is a frequent laparoscopic and hysteroscopic surgical target.
Surgery of the female genital tract can be classified by CPT code 58548. The most frequent procedures this code suggests are endoscopic lymph node biopsy of the aortic arch, hysterectomy, and bilateral pelvic lymph node dissection.
Other categories of CPT codes describe hysterectomy procedures performed through the abdominal cavity. This surgery includes laparoscopic supracervical hysterectomy (LSH) using CPT 58541 to CPT 58544.
Laparoscopy with vaginal hysterectomy (LAVH) can be billed with CPT 58541 to CPT 58544. A larger uterus (250 g or more), with or without a fallopian tube and ovary removal, can be classified as a separate category within each code set. It is the case regardless of whether the ovary and fallopian tubes were removed (s).
For a TLH, the cervix and uterine body can be separated laparoscopically, and the vaginal cuff is closed with sutures. The uterus will then extract through the abdominal or vaginal routes.
Laparoscopic separation of the uterine body from its upper supporting structures is a component of LAVH. The vaginal portion of the procedure comes next. After the cervix and uterus can be introduced into the vaginal apex, their remaining supporting structures must dissect away. Following the completion of the process, the uterus will extract in the same manner.
In laparoscopic hysterectomy, separating the uterine body from the uterine arteries is crucial (LSH). The endocervical canal and cervical stump can be solidified after separating the uterine body and cervix. Following salvation, coring, or morcellation, the uterine body could extract through an abdominal incision. The ACOG Coding team has created charts comparing traditional and laparoscopic hysterectomies.
Description Of The Hysterectomy CPT Codes
The exclusion of hysterectomy CPT codes depends heavily on the type of procedure performed. Access can be laparoscopic, vaginal, or abdominal.
The 18 CPT codes for hysterectomy from CPT 58150 until CPT 58294 are described below.
CPT 58150: CPT code 58150 is described in CPT’s manual as: “Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)”.
CPT 58152: CPT code 58152 is described in CPT’s manual as: “Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch)”
CPT 58180: CPT code 58180 is described in CPT’s manual as: “Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s).”
CPT 58200: CPT code 58200 is described in CPT’s manual as: “Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with or without removal of ovary(s).”
CPT 58210: CPT code 58210 is described in CPT’s manual as: “Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s).”
CPT 58240: CPT code 58240 is described in CPT’s manual as: “Pelvic exenteration for gynecologic malignancy, with total abdominal hysterectomy or cervicectomy, with or without removal of tube(s), with or without removal of ovary(s), with the removal of the bladder and ureteral transplantations, and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof.”
CPT 58260: CPT code 58260 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus 250 g or less.”
CPT 58262: CPT code 58262 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus 250 g or less; with the removal of tube(s), and/or ovary(s).”
CPT 58263: CPT code 58263 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus 250 g or less; with the removal of tube(s), and/or ovary(s), with the repair of enterocele.”
CPT 58267: CPT code 58267 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control.”
CPT 58270: CPT code 58270 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus 250 g or less; with the repair of enterocele.”
CPT 58275: CPT code 58275 is described in CPT’s manual as: “Vaginal hysterectomy, with total or partial vaginectomy.”
CPT 58280: CPT code 58280 is described in CPT’s manual as: “Vaginal hysterectomy, with total or partial vaginectomy; with the repair of enterocele.”
CPT 58285: CPT code 58285 is described in CPT’s manual as: “Vaginal hysterectomy, radical (Schauta type operation).”
CPT 58290: CPT code 58290 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus greater than 250 gram.”
CPT 58291: CPT code 58291 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus greater than 250 g; with the removal of tube(s) and/or ovary(s).”
CPT 58292: CPT code 58292 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus greater than 250 g; with the removal of tube(s) and/or ovary(s), with the repair of enterocele.”
CPT 58294: CPT code 58294 is described in CPT’s manual as: “Vaginal hysterectomy, for uterus greater than 250 g; with the repair of enterocele.”
Hysterectomy Procedures Explained
A hysterectomy procedure involves making a vaginal incision to access and remove the uterus.
The process should be performed through a series of smaller incisions using a laparoscope, a thin, flexible tube. The duration of a hysterectomy procedure is also a consideration in determining the correct diagnosis code.
A total hysterectomy procedure involves suturing the vaginal cuff. Laparoscopy can be used to free the uterine cervix and body from supporting structures. As required, removed tissues may also be bivalved, cored, or morcellated. Afterward, the uterus extracts through the vaginal and abdominal openings.
During a subtotal hysterectomy procedure, the cervix is left in place while the uterine fundus and other parts can remove. A radical hysterectomy entails the removal of the uterus, its surrounding tissue, the cervix, and the upper vaginal wall. The procedure will be performed within the vaginal canal.
Each year, approximately 650,000 hysterectomies are performed in the United States, making it the second most common surgical procedure. A woman’s menstrual periods should be stopped following this procedure, and she will be unable to conceive a child.
Depending on the circumstances, a hysterectomy could perform vaginally, abdominally, or laparoscopically. This procedure, known as a vaginal hysterectomy, involves the surgical removal of the uterus through the vagina. Compared to other methods of hysterectomy, vaginal removal is less invasive, resulting in a faster and easier recovery.
Vaginal hysterectomy is a standard procedure in gynecology practice. When deciding on a code, it is critical to consider the specific surgical technique, the process’s scope, and any previous related procedures (whether the hysterectomy is complete or partial).
An OB-GYN (obstetrician-gynecologist) or another general surgeon should keep meticulous records of all procedures performed on their patients, including vaginal hysterectomies. Doctors can be streamlined their documentation process if they outsource their medical billing and coding to a reputable company.
The uterus will remove its supporting structures (such as the ovaries, fallopian tubes, and upper vagina) and blood vessels during a vaginal hysterectomy. The uterus will then extract through the vaginal opening.
The procedure could take 60 to 90 minutes, depending on the patient’s condition. When a vaginal hysterectomy is feasible, the ACOG recommends it. Surgeons commonly perform this procedure to treat a wide range of gynecological conditions, including:
- Microscopic fibroids in the uterus or a benign uterine growth
- Uterine prolapse occurs when the uterus moves out of its normal position, as the name suggests.
- Intractable uterine cancer will characterize by persistently heavy or irregular menstrual bleeding (involving cancer of the uterus, cervix, endometrium, or ovaries)
- persistent pelvic pain
When women are overweight or have high blood pressure, their surgical risk increases dramatically. A tiny camera will embed the scope, and the video will transmit to a screen.
Billing Guidelines For The CPT Codes For Hysterectomy
A single global charge can be submitted when one or more doctors at the same facility (reporting under the same federal tax identification number) provide care for four or more prenatal visits, the actual delivery, and the postpartum period.
Please be aware that claims with CPT codes for Hysterectomy submitted for partial maternity care with E&M codes for one to three visits will be canceled if billed before the delivery. All claims related to maternity care can be received to account for the correct number of visits.
The total cost of prenatal to postpartum care for a vaginal birth is $5,9400. This code should not be used if fewer than four prenatal visits occurred. After this, it is possible to add modifier 22 or modifier 52.
The 59510 CPT code accounts for the total cost of cesarean delivery, including the initial consultation and postoperative recovery room visit. You should not use this code if you have less than four prenatal visits. The specific 22, 52, AS, and 80 can be used as a modifiers.
The 59610 CPT code can be used for a VBAC delivery, which includes prenatal and postnatal care. This code should not be used for fewer than four prenatal visits. After this, it is possible to add 22 or 52 modifiers.
After attempting vaginal birth after 40 weeks (CPT 59618) and after 40 weeks (CPT 59618) of pregnancy, the patient requested a cesarean section. This code should not be used if fewer than four prenatal visits occurred.
It is worth noting that the RVUs for CPT 58825 and CPT 58860 are incredibly close. Additional reimbursement requires a copy of the procedure note. Use CPT 38751 for laparoscopic pelvic lymph node resection alone and CPT 38572 for paraaortic lymph nodes if the uterus weighs more than 250 grams.
CPT Code 58679 can be used to report ovary, oviduct, and procedure (unlisted laparoscopy). If a procedure code could is used in a claim that is not on the predefined list, the claim must submit manually on paper. Comprehensive adhesion lysis records are required.
How To Use Modifiers For The Hysterectomy CPT Codes
CPT code 38900 can be billed with modifier 50 for bilateral dye injection during sentinel node mapping. Report CPT 38570 with modifier 50 for node biopsy.
If a complete lymph node dissection is required due to non-mapping or another issue, but an injection performs, bill CPT 38900 with modifier 50.
Node removal procedures are done for sentinel nodes or a complete lymphadenectomy if the code for lymph node mapping will refuse CPT 38900.
If no nodes eliminate, CPT code 38900 will not incur. However, you can be added modifier 22 to your bill to account for the additional work that this entails, even though it will already cover itself and is, therefore, not separately billable. Include the extra effort in your operative note.
Modifier 22 will apply when more effort than usual is required to complete the hysterectomy CPT code procedure. When a laparoscopic procedure converts to an open process, modifier 22 will use, but “substantial” additional work must document in the medical records.
In addition, the CPT requires that the extra work will support by evidence. Increased intensity, time, technical difficulty, the severity of the patient’s condition, and physical and mental exertion contribute to the immense workload.
An office visit for pregnancy care requires a one-time copayment. If a BCBS plan requires a copayment, it will collect on the first visit to the obstetrician’s office.
Since payment for a Hysterectomy CPT code procedure is distinct from “global maternity care,” physicians should submit a claim for it during the initial obstetrician visit.
Claims should include a delivery date estimate. The “global maternity care” reimbursement plan pays for all subsequent prenatal and postnatal office visits for hysterectomy procedures.
If a patient receives more than three prenatal visits, delivery, and postpartum care, all maternity-related visits should code with the global maternity code. Individual E&M codes should not use when reporting E&M visits associated with pregnancy.
As prenatal care view as an integral component of the overall reimbursement, it will not be paid separately. Maternity care does not commence with the pregnancy confirmation appointment (verification of benefits will determine appropriate member liability).
A patient whose age is 39 years old and has hereditary nonpolyposis colon cancer (HNPCC). The gynecologist will suggest a hysterectomy CPT code procedure.