2025 CPT code 58553
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Feed
Laparoscopy, surgical, with vaginal hysterectomy, for a uterus greater than 250 g.
Modifiers may be applicable to indicate specific circumstances like increased procedural services (22), multiple procedures (51), or other situations impacting the service provided.Refer to current CPT guidelines for appropriate modifier usage.
Medical necessity must be established based on the patient's symptoms, the size of the uterus, and failure of conservative management options. Examples of medically necessary reasons include persistent bleeding, pain, pelvic pressure, or other symptoms caused by a large uterus (often due to fibroids).
The surgeon performs the procedure which involves a combination of laparoscopic and vaginal techniques. Laparoscopically, the surgeon visualizes and dissects the upper uterine attachments (round ligaments, fallopian tubes, ovarian ligaments, broad ligament, uterine vessels).Vaginally, the surgeon detaches the uterus from supporting structures (uterosacral and cardinal ligaments) and removes it along with the cervix. The vaginal cuff is then closed.
In simple words: The doctor removes the uterus and cervix through the vagina.A small camera (laparoscope) is inserted through small incisions in the abdomen to help cut the connections holding the uterus in place. This is done for a larger than normal uterus, usually because of fibroids.
This procedure involves the removal of the uterus and cervix through the vagina (vaginal hysterectomy) with the assistance of laparoscopy. The laparoscopic approach is used to sever the upper uterine attachments, facilitating the vaginal removal.This code is specifically for uteri weighing more than 250 grams, often due to fibroids.
Example 1: A 45-year-old woman with symptomatic uterine fibroids causing a uterine weight greater than 250 g undergoes a laparoscopically assisted vaginal hysterectomy (LAVH)., A 50-year-old woman with heavy and prolonged menstrual bleeding due to a large, fibroid-filled uterus exceeding 250 g undergoes LAVH. , A patient with a uterus greater than 250g and a history of endometriosis undergoes LAVH.
Documentation should include the size and weight of the uterus, confirmation of the vaginal hysterectomy approach with laparoscopic assistance, operative details of the laparoscopic dissection, and any associated procedures like removal of tubes or ovaries (salpingo-oophorectomy).
- Specialties:Obstetrics and Gynecology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center