Thanks for your question on the proper coding of hysterectomies today.
I'm sure your gynecologic surgeon thanks you for investigating these
The reason for the switch in CPT codes was to allow for complexity in
laparoscopic procedural codes. This articles gives the highlights and
also contains important modifier information.
"With the older codes, there was no way to capture the additional
physician work involved in a complex vaginal hysterectomy, such as one
with a very large uterus (...). The new codes sought to rectify that
"The new code 58552 should be entered if the uterus weighs 250 grams
or less, and the ovaries and/or fallopian tubes were removed. Number
58553 covers a laparoscopic vaginal hysterectomy for a uterus greater
than 250 grams. And 58554 should be used for the larger uterus
combined with ovary and/or tube removal."
Also with the 2003 CPT changes come two additional codes for
"Two new laparoscopic myomectomy codes will come into play as of
January 1, 2003. The first, 58545, will cover removal of one to four
intramural myomas with a total weight of 250 grams or less and/or the
removal of surface fibroids. The other, 58546, should be used for
removal of five or more intramural myomas and/or intramural myomas
weighing more than 250 grams."
If you have any coding questions specific to these new codes, here is
ACOG's contact information:
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