Managing laparoscopic supracervical hysterectomy for uteri larger than 250 grams presents unique clinical and administrative challenges. The increased uterine size adds technical complexity, potential operative risk, and documentation requirements that directly affect coding and reimbursement.
Leveraging OBGYN medical billing services ensures that all procedural details, including uterine weight, operative approach, and intraoperative findings, are accurately captured, claims are submitted correctly, and denials are minimized, allowing physicians to focus on delivering high-quality patient care.
CPT Code 58543 – Description
The official definition of CPT code 58543 is:
“Laparoscopic supracervical hysterectomy, uterus greater than 250 g.”
This code is used for a minimally invasive laparoscopic procedure in which the physician removes the uterine body while preserving the cervix in cases where the uterus exceeds 250 grams in weight. The procedure is commonly performed for benign gynecologic conditions associated with uterine enlargement, such as large fibroids, adenomyosis, or chronic abnormal uterine bleeding.
The scope of CPT 58543 includes placement of laparoscopic ports, abdominal entry, dissection and removal of the enlarged uterine body, preservation of the cervix, achievement of hemostasis, and closure of laparoscopic port sites. This code is distinct from CPT 58541 and CPT 58542, which apply only when the uterus weighs 250 grams or less.
Scenarios Where CPT Code 58543 Is Applicable
You would bill CPT code 58543 in the following situations:
Benign Conditions With Enlarged Uterus:
When a patient has benign gynecologic conditions such as large uterine fibroids, adenomyosis, or abnormal uterine bleeding associated with a uterus weighing more than 250 grams.
Example:
A patient with multiple large fibroids and an enlarged uterus undergoes a laparoscopic supracervical hysterectomy. The cervix is preserved, and the uterine weight exceeds 250 grams.
Minimally Invasive Surgical Approach:
When the procedure is completed entirely via laparoscopy without conversion to an open abdominal approach.
Uterine Weight Threshold:
When the uterus is documented as weighing more than 250 grams, either by intraoperative estimation or postoperative pathology.
Applicable Modifiers for CPT Code 58543
The following modifiers may be used with CPT code 58543 when appropriate:
Modifier 22 – Increased Procedural Services
Used when the procedure requires significantly increased time or effort due to factors such as extensive adhesions, distorted pelvic anatomy, or unusually large uterine size.
Modifier 51 – Multiple Procedures
Applicable when CPT 58543 is performed during the same operative session as another significant, separately reportable procedure.
Modifier 59 – Distinct Procedural Service
Used when a distinct, non-bundled procedure is performed during the same surgical encounter.
Modifier 62 – Two Surgeons
Reported when two surgeons share responsibility for the main portions of the procedure due to complexity.
Assistant Surgeon Modifiers (80, 81, 82)
Used when an assistant surgeon is medically necessary.
All modifier usage must be clearly supported by operative documentation.
CPT Code 58543 – Billing & Reimbursement
To ensure proper reimbursement for CPT code 58543, follow these key steps:
Justify Medical Necessity:
Document the patient’s symptoms and diagnoses, such as large fibroids, adenomyosis, or abnormal uterine bleeding, that support the need for supracervical hysterectomy.
Use Accurate ICD-10 Codes:
CPT 58543 must be paired with diagnosis codes that reflect benign gynecologic conditions and uterine enlargement.
Confirm Surgical Details:
The operative report should clearly document:
- Laparoscopic approach
- Preservation of the cervix
- Uterine weight greater than 250 grams
Detailed Documentation:
Ensure the operative note includes surgical steps, estimated or confirmed uterine weight, intraoperative findings, hemostasis, and closure of laparoscopic port sites.
Reimbursement Considerations:
Reimbursement varies based on payer policy, place of service, and geographic location. Clear documentation of uterine size is essential to distinguish CPT 58543 from codes used for smaller uteri and to prevent downcoding or denial.
BillingFreedom: Expert Support for Laparoscopic Supracervical Hysterectomy on Enlarged Uteri
Managing laparoscopic supracervical hysterectomy for uteri over 250 grams requires precise documentation, accurate coding, and proper modifier use. The increased uterine size adds technical complexity, making thorough operative notes and documentation critical for reimbursement and claim approval.
BillingFreedom provides specialized OBGYN medical billing services in Tennessee to handle these intricate procedures efficiently. Our team ensures every claim is accurately coded, fully documented, and compliant with payer guidelines. From preauthorization to operative reporting and modifier selection, we streamline the billing process, helping practices maximize reimbursement while allowing physicians to focus on patient care.
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Related ICD-10-CM Codes
ICD-10-CM Codes
C54.0 - Malignant neoplasm of isthmus uteri
C54.1 - Malignant neoplasm of endometrium
C54.2 - Malignant neoplasm of myometrium
C54.3 - Malignant neoplasm of fundus uteri
C54.8 - Malignant neoplasm of overlapping sites of corpus uteri
C54.9 - Malignant neoplasm of corpus uteri, unspecified
C55 - Malignant neoplasm of uterus, part unspecified
C57.10 - Malignant neoplasm of unspecified broad ligament
C57.11 - Malignant neoplasm of right broad ligament
C57.12 - Malignant neoplasm of left broad ligament
C57.20 - Malignant neoplasm of unspecified round ligament
C57.21 - Malignant neoplasm of right round ligament
C57.22 - Malignant neoplasm of left round ligament
C57.3 - Malignant neoplasm of parametrium
C57.4 - Malignant neoplasm of uterine adnexa, unspecified
C57.7 - Malignant neoplasm of other specified female genital organs
C57.8 - Malignant neoplasm of overlapping sites of female genital organs
C57.9 - Malignant neoplasm of female genital organ, unspecified
C79.82 - Secondary malignant neoplasm of genital organs
D07.0 - Carcinoma in situ of endometrium
D07.30 - Carcinoma in situ of unspecified female genital organs
D07.39 - Carcinoma in situ of other female genital organs
D25.0 - Submucous leiomyoma of uterus
D25.1 - Intramural leiomyoma of uterus
D25.2 - Subserosal leiomyoma of uterus
D25.9 - Leiomyoma of uterus, unspecified
D39.0 - Neoplasm of uncertain behavior of uterus
D39.2 - Neoplasm of uncertain behavior of placenta
D39.8 - Neoplasm of uncertain behavior of other specified female genital organs
D39.9 - Neoplasm of uncertain behavior of female genital organ, unspecified
N71.0 - Acute inflammatory disease of uterus
N71.1 - Chronic inflammatory disease of uterus
N71.9 - Inflammatory disease of uterus, unspecified
N73.0 - Acute parametritis and pelvic cellulitis
N73.1 - Chronic parametritis and pelvic cellulitis
N73.2 - Unspecified parametritis and pelvic cellulitis
N73.3 - Female acute pelvic peritonitis
N73.4 - Female chronic pelvic peritonitis
N73.5 - Female pelvic peritonitis, unspecified
N73.6 - Female pelvic peritoneal adhesions (postinfective)
N73.8 - Other specified female pelvic inflammatory diseases
N73.9 - Female pelvic inflammatory disease, unspecified
N74 - Female pelvic inflammatory disorders in diseases classified elsewhere
N80.00 - Endometriosis of the uterus, unspecified
N80.02 - Deep endometriosis of the uterus
N80.03 - Adenomyosis of the uterus
N80.101 - Endometriosis of right ovary, unspecified depth
N80.102 - Endometriosis of left ovary, unspecified depth
N80.103 - Endometriosis of bilateral ovaries, unspecified depth
N80.109 - Endometriosis of ovary, unspecified side, unspecified depth
N80.381 - Endometriosis of the right pelvic brim, unspecified depth
N80.382 - Endometriosis of the left pelvic brim, unspecified depth
N80.383 - Endometriosis of bilateral pelvic brim, unspecified depth
N80.389 - Endometriosis of the pelvic brim, unspecified side, unspecified depth
N80.391 - Superficial endometriosis of the pelvic peritoneum, other specified sites
N80.392 - Deep endometriosis of the pelvic peritoneum, other specified sites
N80.399 - Endometriosis of the pelvic peritoneum, other specified sites, unspecified depth
N81.2 - Incomplete uterovaginal prolapse
N81.3 - Complete uterovaginal prolapse
N81.4 - Uterovaginal prolapse, unspecified
N81.89 - Other female genital prolapse
N84.0 - Polyp of corpus uteri
N84.8 - Polyp of other parts of female genital tract
N84.9 - Polyp of female genital tract, unspecified
N85.00 - Endometrial hyperplasia, unspecified
N85.01 - Benign endometrial hyperplasia
N85.02 - Endometrial intraepithelial neoplasia [EIN]
N85.2 - Hypertrophy of uterus
N85.7 - Hematometra
N85.8 - Other specified noninflammatory disorders of uterus
N85.9 - Noninflammatory disorder of uterus, unspecified
N87.0 - Mild cervical dysplasia
N87.1 - Moderate cervical dysplasia
N87.9 - Dysplasia of cervix uteri, unspecified
N92.0 - Excessive and frequent menstruation with regular cycle
N92.1 - Excessive and frequent menstruation with irregular cycle
N92.5 - Other specified irregular menstruation
N93.8 - Other specified abnormal uterine and vaginal bleeding
N93.9 - Abnormal uterine and vaginal bleeding, unspecified
N94.89 - Other specified conditions associated with female genital organs and menstrual cycle
N95.0 - Postmenopausal bleeding
N71.0 - Acute inflammatory disease of uterus
N71.1 - Chronic inflammatory disease of uterus
N71.9 - Inflammatory disease of uterus, unspecified
N73.0 - Acute parametritis and pelvic cellulitis
N73.1 - Chronic parametritis and pelvic cellulitis
N73.2 - Unspecified parametritis and pelvic cellulitis
N73.3 - Female acute pelvic peritonitis
N73.4 - Female chronic pelvic peritonitis
N73.5 - Female pelvic peritonitis, unspecified
N73.6 - Female pelvic peritoneal adhesions (postinfective)
N73.8 - Other specified female pelvic inflammatory diseases
N73.9 - Female pelvic inflammatory disease, unspecified
N74 - Female pelvic inflammatory disorders in diseases classified elsewhere
N80.00 - Endometriosis of the uterus, unspecified
N80.02 - Deep endometriosis of the uterus
N80.03 - Adenomyosis of the uterus
N80.101 - Endometriosis of right ovary, unspecified depth
N80.102 - Endometriosis of left ovary, unspecified depth
N80.103 - Endometriosis of bilateral ovaries, unspecified depth
N80.109 - Endometriosis of ovary, unspecified side, unspecified depth
N80.381 - Endometriosis of the right pelvic brim, unspecified depth
N80.382 - Endometriosis of the left pelvic brim, unspecified depth
N80.383 - Endometriosis of bilateral pelvic brim, unspecified depth
N80.389 - Endometriosis of the pelvic brim, unspecified side, unspecified depth
N80.391 - Superficial endometriosis of the pelvic peritoneum, other specified sites
N80.392 - Deep endometriosis of the pelvic peritoneum, other specified sites
N80.399 - Endometriosis of the pelvic peritoneum, other specified sites, unspecified depth
N81.2 - Incomplete uterovaginal prolapse
N81.3 - Complete uterovaginal prolapse
N81.4 - Uterovaginal prolapse, unspecified
N81.89 - Other female genital prolapse
N84.0 - Polyp of corpus uteri
N84.8 - Polyp of other parts of female genital tract
N84.9 - Polyp of female genital tract, unspecified
N85.00 - Endometrial hyperplasia, unspecified
N85.01 - Benign endometrial hyperplasia
N85.02 - Endometrial intraepithelial neoplasia [EIN]
N85.2 - Hypertrophy of uterus
N85.7 - Hematometra
N85.8 - Other specified noninflammatory disorders of uterus
N85.9 - Noninflammatory disorder of uterus, unspecified
N87.0 - Mild cervical dysplasia
N87.1 - Moderate cervical dysplasia
N87.9 - Dysplasia of cervix uteri, unspecified
N92.0 - Excessive and frequent menstruation with regular cycle
N92.1 - Excessive and frequent menstruation with irregular cycle
N92.5 - Other specified irregular menstruation
N93.8 - Other specified abnormal uterine and vaginal bleeding
N93.9 - Abnormal uterine and vaginal bleeding, unspecified
N94.89 - Other specified conditions associated with female genital organs and menstrual cycle
N95.0 - Postmenopausal bleeding
O86.04 - Sepsis following an obstetrical procedure
Related CPT Codes
CPT Codes
58520 - Repair of Ruptured Uterus (Non-Obstetrical)
58540 - Hysteroplasty for Uterine Anomaly: Comprehensive Coding and Billing Guideline
58541 - Laparoscopy, Supracervical Hysterectomy, Uterus 250 g or Less
58542 - Laparoscopic Supracervical Hysterectomy with Removal of Tubes and/or Ovaries
58544 - Laparoscopic Supracervical Hysterectomy with Adnexal Removal for Uterus >250 g
58548 - Laparoscopic Radical Hysterectomy with Pelvic & Para‑aortic Lymphadenectomy
58553 - Laparoscopically Assisted Vaginal Hysterectomy (Uterus >250 g with Adnexal Removal)