Ob-Gyn Coding for Laparoscopic Hysterectomy

Do you sometimes get confused on what CPT code to use when a laparoscopic hysterectomy has been performed?  Here is some information that helps provide structure to the codes available. 

Laparoscopic Hysterectomy can be divided into three major code sets.  Aside from CPT code 58548, the CPT codes in each code set are differentiated by the size of the uterus (less than or greater than 250 grams) and whether or not the tubes and ovaries are removed.   

The first code set is categorized as Laparoscopic Supracervical Hysterectomy (LSH), indicated by CPT codes 58541 to 58544.  LSH includes laparoscopically detaching the body of the uterus down to the uterine arteries. The uterine body is then separated from the cervix, hemostasis of the cervical stump is achieved, and the endocervical canal is coagulated. The uterine body is then abdominally removed by bivalving, coring, or morcellating, as required.

The second code set is for Laparoscopy with Vaginal Hysterectomy (LAVH), indicated by CPT codes 58550 to 58554.  LAVH includes laparoscopically detaching the uterine body from the surrounding upper supporting structures. The vaginal portion of the procedure is then performed. The vaginal apex is entered and the cervix and uterus are detached from the remaining supporting structures. The uterus is then removed through the vagina. 

The final code set is for Total Laparoscopic Hysterectomy (TLH), indicated by CPT codes 58570 to 58573.  Although it is not in numerical sequence with TLH, you would also include laparoscopic radical hysterectomy with pelvic lymphadenectomy (CPT 58548) in this code set.  TLH includes laparoscopically detaching the entire uterine cervix and body from the surrounding supporting structures and suturing the vaginal cuff.  It includes bivalving, coring, or morcellating the excised tissues, as required. The uterus is then removed through the vagina or abdomen.

Other resources are available on this topic including your current CPT Book, the American Congress of Obstetricians and Gynecologists (ACOG) website, and the American Medical Association’s CPT Assistant.