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2025 CPT code 58572

Total laparoscopic hysterectomy for a uterus weighing over 250 g.

Code 58572 is specific to a total laparoscopic hysterectomy when the uterus weighs more than 250 g. If the uterus weighs less, or if the procedure is laparoscopic-assisted vaginal hysterectomy, a different code should be used.

Medical necessity for this procedure is established by documenting symptomatic conditions related to the enlarged uterus, such as pelvic pain, heavy bleeding, or prolapse, that are refractory to conservative management.

The surgeon is responsible for all aspects of the surgical procedure, including patient positioning, anesthesia, incisions, dissection of the uterus and cervix, morcellation (if needed), closure of the vaginal cuff, and post-operative care.

In simple words: The doctor removes the uterus and cervix through small incisions in the belly using a camera and special tools. Because the uterus is enlarged (weighs more than 250 grams), it may be cut into smaller pieces for removal. The top of the vagina is then closed with stitches.

This procedure involves the complete removal of the uterus and cervix through a laparoscope, for cases where the uterus weighs more than 250 grams, typically due to fibroids. The surgeon makes small incisions to insert instruments and a camera, dissects the uterus and cervix from surrounding tissues and ligaments, and removes the organs either vaginally or through the incisions using a morcellator if necessary. The vaginal cuff is then closed laparoscopically.

Example 1: A 45-year-old woman with symptomatic uterine fibroids causing heavy bleeding and a uterus weighing 280 g undergoes a total laparoscopic hysterectomy., A 50-year-old woman with a 300 g uterus and a diagnosis of adenomyosis undergoes a total laparoscopic hysterectomy for pain management., A 60-year-old woman with a prolapsed uterus exceeding 250 g undergoes total laparoscopic hysterectomy.

Documentation should include the size and weight of the uterus, the indication for surgery (e.g., fibroids, adenomyosis), operative details, including any complications, and post-operative instructions.

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