2025 CPT code 58999
(Active) Effective Date: N/A Revision Date: N/A Deletion Date: N/A Surgery - Other Procedures on the Female Genital System Surgical Procedures on the Female Genital System Feed
Unlisted procedure on the female genital system (excluding obstetrical procedures).
Modifiers may be applicable depending on the circumstances of the procedure.Appropriate modifier usage should be determined based on the specific situation.
The medical necessity of the unlisted procedure must be clearly documented and justified in the medical record.This documentation should connect the performed procedure to the patient's clinical presentation and demonstrate that it was necessary for the diagnosis or treatment of the condition.
The physician or other qualified healthcare professional performing the procedure on the female genital system is responsible for the billing accuracy and the documentation to support the medical necessity of the unlisted procedure.
- Surgical Procedures on the Female Genital System
- 58999 falls under the broader category of surgical procedures on the female genital system (CPT codes 56405-58999).
In simple words: This code is used when a doctor does something to a woman's reproductive organs that isn't listed in the standard medical billing codes.The doctor must explain exactly what they did in detail to get paid.
CPT code 58999 represents an unlisted procedure performed on the female genital system that doesn't have a specific CPT code.This code is utilized when no other existing CPT code accurately describes the performed procedure.Documentation must meticulously detail the procedure performed, including its specifics and rationale for using an unlisted code rather than an existing one.Supporting documentation such as operative reports and other relevant clinical records should be included to support the claim for reimbursement.
Example 1: A patient presents with a complex uterine fibroid requiring a novel surgical technique not captured by other CPT codes.The surgeon uses 58999 while providing a detailed operative report and rationale for using the unlisted code., A patient undergoes a laparoscopic procedure to repair an unusual vaginal injury not specifically addressed in existing CPT codes.The physician documents the procedure in detail and supports the use of 58999 with thorough documentation., During a hysterectomy, the surgeon encounters an unexpected anatomical variation requiring a unique surgical approach to address a specific complication not represented in existing codes. The surgeon uses code 58999 with precise documentation of the variation and the specific procedure.
* Detailed operative report describing the procedure in detail.* Justification for using 58999, including why other codes were not appropriate.* Preoperative and postoperative diagnoses and notes.* Any relevant imaging studies.* Documentation of medical necessity.
** Because this is an unlisted code, thorough documentation is paramount.Claims should include a detailed explanation and justification for using this code and supporting clinical information.Failure to do so may result in claim denials.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- RVU: RVUs will vary depending on the specific procedure performed and the geographic location.The payer will determine reimbursement based on the documentation provided.
- Global Days: The global period will vary depending on the specific procedure.Documentation must clearly define the procedures included within the global surgical period.
- Payment Status: Active, but payment is determined on a case-by-case basis by the payer.
- Modifier TC rule: TC modifier applicability depends on the components of the procedure and should be determined based on the specific facts.
- Fee Schedule: Historical fee schedules are unavailable for this unlisted code. Reimbursement is determined on a case-by-case basis.
- Specialties:Obstetrics and Gynecology
- Place of Service:The place of service will depend on the clinical setting where the procedure is performed (e.g., inpatient hospital, outpatient surgical center, office).