Here’s How New Hysterectomy Code 58575 Compares to Other Code Options

gynecology cpt coding

We’re coming to the end of Cervical Health Awareness Month, in case you didn’t know. And in a roundabout way, that makes me think of the new 2018 hysterectomy code 58575 (Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed). How does this new code compare to existing options? Let’s find out.

Start With the Approach

The approach the surgeon takes is a defining factor in hysterectomy code choice, and new code 58575 helps you start narrowing your code options quickly by making “laparoscopy” the first word in the descriptor.

Here’s the basic breakdown when it comes to defining hysterectomy code options by approach:

  • Open, abdominal: 58150-58240, 58951, 58953-58956
  • Vaginal: 58260-58294
  • Laparoscopic-assisted, vaginal (LAVH): 58550-58554
  • Laparoscopic: 58541-58544, 58570-58573, 58575.

What’s Missing From 58575? Uterine Size

Many hysterectomy code descriptors include the size of the uterus. For instance, the size of the uterus is the only difference between 58260 (Vaginal hysterectomy, for uterus 250 g or less) and 58290 (Vaginal hysterectomy, for uterus greater than 250 g). The pathology report should include the size of the uterus so you can select the appropriate code.

For 58575, uterine size is not defined in the descriptor, and therefore that size does not affect your code choice. You’ll also find the size requirement missing from the code for the same service by an open approach, 58953 (Bilateral salpingo-oophorectomy with omentectomy, total abdominal hysterectomy and radical dissection for debulking).

Watch for Extent of Removal

Code 58575 is specific to total hysterectomy. But total isn’t the only option for a hysterectomy, as experienced ob-gyn coders know. For instance, codes 58180, 58541, and 58542 apply to supracervical hysterectomy, where the surgeon removes the uterus, but not the cervix.

To choose the correct hysterectomy code, you’ve also got to know what other services were performed at the same time and match that to the descriptor. For instance, based on the descriptor for 58575, the code covers total hysterectomy for tumor debulking, omentectomy (removal of the omentum, part of the membrane lining the abdominal cavity), and salpingo-oophorectomy (removal of the fallopian tubes and ovaries). You’ve got to be alert for key words in the descriptor that let you know what is and isn’t required, too. In 58575, that last part “unilateral or bilateral” lets you know the code applies and pays the same regardless of whether that part of the procedure is on one or both sides. And “when performed” lets you know a particular service isn’t required for you to report the code, but the service is included (not reported separately) if the surgeon does perform it.

How About You?

Do you use the same few hysterectomy codes over and over? Or do you use a wide range of codes?

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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