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The procedure described by CPT® Code 58550 refers to a laparoscopically assisted vaginal hysterectomy (LAVH) performed on a uterus that weighs 250 grams or less. This surgical technique combines the benefits of laparoscopic surgery with traditional vaginal hysterectomy methods. During the procedure, the physician makes a small incision just below the umbilicus to insert a trocar, which allows for the introduction of a laparoscope. This instrument provides a visual inspection of the abdominal cavity and the uterus, facilitating the surgical process. The procedure may involve the removal of the uterus alone or, in some cases, the removal of additional structures such as the fallopian tubes and/or ovaries, although the primary focus of this code is on the hysterectomy itself. The use of bipolar coagulation is critical for controlling bleeding throughout the surgery, ensuring a safer and more efficient operation. The detailed steps of the procedure involve careful dissection and manipulation of various ligaments and tissues, ultimately leading to the removal of the uterus through the vaginal canal. This minimally invasive approach is designed to reduce recovery time and postoperative complications compared to traditional open hysterectomy techniques.
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The laparoscopically assisted vaginal hysterectomy (LAVH) procedure, as described by CPT® Code 58550, is indicated for patients presenting with specific conditions related to the uterus. These indications may include:
The laparoscopically assisted vaginal hysterectomy (LAVH) procedure involves several key steps, which are detailed as follows:
After the laparoscopically assisted vaginal hysterectomy (LAVH) procedure, patients can expect specific post-operative care and recovery considerations. It is essential to monitor for any signs of complications, such as excessive bleeding or infection. Patients are typically advised to rest and limit physical activity for a period to promote healing. Pain management may be necessary, and physicians may prescribe medications to alleviate discomfort. Follow-up appointments are crucial to assess recovery progress and address any concerns. Patients should also be informed about signs of potential complications that warrant immediate medical attention, such as severe abdominal pain, fever, or unusual discharge. Overall, the recovery period may vary, but many patients experience a quicker recovery compared to traditional open hysterectomy methods.
| Short Descr | LAPARO-ASST VAG HYSTERECTOMY | Medium Descr | LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/< | Long Descr | Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less; | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 124 - Hysterectomy, abdominal and vaginal |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 53 | Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2010-01-01 | Changed | Code description changed. |
| 2007-01-01 | Changed | Code description changed. |
| 2003-01-01 | Changed | Code description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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