CPT Code 58559 Surgical Hysteroscopy with Lysis of Intrauterine Adhesions

Surgical hysteroscopy with lysis of intrauterine adhesions is a minimally invasive procedure designed to restore normal uterine cavity anatomy. 

This intervention is essential for patients affected by Asherman syndrome or intrauterine synechiae, which can result from prior uterine surgery, infection, or trauma. Women may experience infertility, recurrent pregnancy loss, menstrual abnormalities, or pelvic pain due to adhesions. 

By visualizing and surgically removing scar tissue, physicians can improve fertility outcomes, alleviate symptoms, and prevent future complications. Proper coding, documentation, and billing are critical for reimbursement and claim accuracy.

CPT Code 58559 – Description

The official definition of CPT code 58559 is:

“Hysteroscopy, surgical; with lysis of intrauterine adhesions (any method).”

This code describes a minimally invasive operative procedure in which a hysteroscope is inserted through the cervix to access the uterine cavity. The procedure involves identification and removal of intrauterine adhesions or scar tissue using any method, including scissors, blunt dissection, electrosurgery, or laser. Diagnostic hysteroscopy (CPT 58555) is bundled and not separately billable during this procedure. CPT 58559 can be reported alongside other distinct hysteroscopic procedures (e.g., CPT 58558, 58560) if documentation supports them as separate services per NCCI guidelines.

The scope of CPT 58559 includes insertion of the hysteroscope, identification and removal of adhesions, full assessment of the uterine cavity to ensure complete lysis, and recording operative details for follow-up and clinical assessment.

Scenarios Where CPT Code 58559 Is Applicable

You would bill CPT code 58559 in the following situations:

Treatment of Intrauterine Adhesions (Asherman’s Syndrome):

When a patient presents with menstrual abnormalities, infertility, or recurrent pregnancy loss due to intrauterine adhesions. The surgeon performs hysteroscopic lysis using scissors, electrosurgery, or laser to restore uterine function.

Example:

A patient with a history of postpartum curettage develops intrauterine adhesions causing amenorrhea. The surgeon performs hysteroscopic lysis of adhesions, documenting complete removal and restoration of the uterine cavity.

Standalone or Combined Procedures:

CPT 58559 may be performed alone or in conjunction with other hysteroscopic procedures (e.g., polypectomy, myomectomy), provided documentation supports each procedure as distinct.

Applicable Modifiers for CPT Code 58559

The following modifiers may be used with CPT code 58559 when appropriate:

Modifier 22 – Increased Procedural Services

Used if the lysis is technically challenging due to extensive adhesions, abnormal anatomy, or increased operative time.

Modifier 51 – Multiple Procedures

Applicable when CPT 58559 is performed during the same session as another significant, separately reportable procedure.

Modifier 59 – Distinct Procedural Service

Used if a separate hysteroscopic procedure is performed and clearly documented.

Modifier 25 – Significant, Separately Identifiable E/M Service

Reported if an evaluation and management service is provided on the same day, beyond routine pre- and post-procedure care.

All modifier usage must be supported by detailed operative documentation.

CPT Code 58559 – Billing & Reimbursement

To ensure proper reimbursement for CPT code 58559, follow these key steps:

Justify Medical Necessity:

Document the patient’s diagnosis, including intrauterine adhesions, clinical symptoms, and the rationale for hysteroscopic lysis.

Use Accurate ICD-10 Codes:

Pair CPT 58559 with diagnosis codes that reflect intrauterine adhesions, infertility, or other clinically relevant conditions.

Confirm Procedural Details:

The operative report should clearly document:

• Insertion of hysteroscope and uterine access
• Identification and complete lysis of intrauterine adhesions
• Method used (scissors, electrosurgery, laser, or blunt dissection)
• Restoration of the uterine cavity and any operative challenges

Detailed Documentation:

Ensure all steps of the procedure are recorded, including complications, operative time, and intraoperative findings to support modifiers and payer compliance.

Reimbursement Considerations:

CPT 58559 reimbursement depends on accurate documentation and payer-specific bundling rules. Proper coding differentiates this procedure from diagnostic hysteroscopy (CPT 58555) and other hysteroscopic interventions, ensuring correct payment and minimizing claim denials.

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