Total laparoscopic hysterectomy (TLH) for a uterus greater than 250 grams is a minimally invasive surgical procedure used to remove the uterus, including the cervix, through small abdominal incisions.
This approach reduces recovery time, blood loss, and postoperative pain compared to open surgery. Accurate coding and documentation are essential to ensure proper reimbursement and reflect the complexity of the procedure, particularly in cases involving large uteri or additional surgical challenges.
CPT Code 58572 – Description
The official definition of CPT code 58572 is:
“Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g.”
This code describes a therapeutic laparoscopic procedure in which the uterus, including the cervix, is completely removed. The procedure involves laparoscopic entry into the abdominal cavity using trocars and specialized instruments, colpotomy, closure of the vaginal cuff, and lysis of minor adhesions if necessary. Removal of fallopian tubes or ovaries is not included in this code (use CPT 58573 if adnexa are removed).
Documentation must clearly confirm the uterine weight >250 grams to differentiate from CPT 58570 for smaller uteri.
Scenarios Where CPT Code 58572 Is Applicable
You would bill CPT code 58572 in the following situations:
Symptomatic Uterus >250 g:
When a patient has a large uterus due to benign conditions such as fibroids, adenomyosis, or abnormal uterine bleeding, and a total laparoscopic hysterectomy is performed.
Example:
A patient with multiple large fibroids resulting in a uterine weight of 300 g undergoes a laparoscopic total hysterectomy. Operative notes confirm complete uterine removal, colpotomy, vaginal cuff closure, and minor adhesiolysis.
Technical Complexity:
If minor adhesions or difficult anatomy are present, detailed documentation is needed to justify increased procedural complexity or extended operative time.
Applicable Modifiers for CPT Code 58572
The following modifier may be used with CPT code 58572 when appropriate:
Modifier 22 – Increased Procedural Services
Applicable if the procedure requires additional effort due to extensive adhesions, difficult anatomy, or operative time exceeding standard expectations. Documentation must clearly justify the increased service.
No other modifiers are routinely required for this code unless payer-specific instructions indicate otherwise.
CPT Code 58572 – Billing & Reimbursement
To ensure proper reimbursement for CPT code 58572, follow these key steps:
Justify Medical Necessity:
Document the clinical indication for total hysterectomy, including symptomatic fibroids, adenomyosis, or abnormal bleeding, and uterine weight >250 g.
Use Accurate ICD-10 Codes:
Pair CPT 58572 with diagnosis codes reflecting the underlying benign condition, such as D25.x (fibroids) or N80.x (adenomyosis).
Confirm Procedural Details:
The operative report should clearly document:
- Laparoscopic entry and abdominal access
- Complete removal of the uterus including the cervix
- Colpotomy and closure of the vaginal cuff
- Lysis of minor adhesions if applicable
- Uterine weight or pathology confirmation
Detailed Documentation:
Include any operative challenges, adhesions, or technical complexity to support modifier 22 and ensure payer compliance.
Reimbursement Considerations:
CPT 58572 reimbursement depends on documentation showing uterine size, laparoscopic approach, and any increased procedural complexity. Proper coding differentiates this procedure from smaller uterus hysterectomies and ensures accurate payer recognition and payment.
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Related ICD-10-CM Codes
ICD-10-CM Codes
C53.0 - Malignant neoplasm of endocervix
C53.1 - Malignant neoplasm of exocervix
C53.8 - Malignant neoplasm of overlapping sites of cervix uteri
C53.9 - Malignant neoplasm of cervix uteri, unspecified
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
D06.0 - Carcinoma in situ of endocervix
D06.1 - Carcinoma in situ of exocervix
D06.7 - Carcinoma in situ of other parts of cervix
D06.9 - Carcinoma in situ of cervix, unspecified
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
N72 - Inflammatory disease of cervix uteri
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
Related CPT Codes
CPT Codes
58559 - Surgical Hysteroscopy with Lysis of Intrauterine Adhesions
58560 - Surgical Hysteroscopy with Division or Resection of Intrauterine Septum
58565 - Surgical Hysteroscopy with Bilateral Fallopian Tube Cannulation and Implant Placement
58575 - Complete Coding & Billing Guide for Laparoscopic Oncologic Hysterectomy with Omentectomy
58580 - Transcervical Radiofrequency Ablation of Uterine Fibroids
58605 - Complete Guide to Postpartum Tubal Ligation (Abdominal or Vaginal Approach)
58552 - Laparoscopically Assisted Vaginal Hysterectomy (Uterus >250 g)
58553 - Laparoscopically Assisted Vaginal Hysterectomy (Uterus >250 g with Adnexal Removal)