CPT code 58180 is for a supracervical abdominal hysterectomy, which may include the removal of tubes and/or ovaries.
CPT code 58180 is used to describe a supracervical abdominal hysterectomy, also known as a subtotal hysterectomy. This surgical procedure involves the removal of the uterus while leaving the cervix intact. The code also accounts for the possibility of removing one or both fallopian tubes and/or ovaries during the procedure, though these additional removals are not mandatory for the use of this code. This code is essential for healthcare providers to accurately document and bill for the specific services rendered during the surgery, ensuring proper reimbursement and maintaining precise medical records.
For CPT code 58180, the following modifiers may be applicable depending on the specific circumstances of the procedure:
1. Modifier 22 - Increased Procedural Services: Use this modifier if the procedure required significantly more work than typically required. This could be due to complications or unexpected findings during surgery.
2. Modifier 51 - Multiple Procedures: If the supracervical abdominal hysterectomy is performed in conjunction with other procedures during the same surgical session, this modifier may be necessary to indicate multiple procedures.
3. Modifier 52 - Reduced Services: Apply this modifier if the procedure was partially reduced or eliminated at the discretion of the physician.
4. Modifier 59 - Distinct Procedural Service: Use this modifier to indicate that a procedure or service was distinct or independent from other services performed on the same day.
5. Modifier 78 - Unplanned Return to the Operating/Procedure Room by the Same Physician Following Initial Procedure for a Related Procedure During the Postoperative Period: This modifier is used if the patient needs to return to the operating room for a related procedure during the postoperative period.
6. Modifier 79 - Unrelated Procedure or Service by the Same Physician During the Postoperative Period: Use this modifier if an unrelated procedure is performed by the same physician during the postoperative period of the initial surgery.
7. Modifier 80 - Assistant Surgeon: If an assistant surgeon is required during the procedure, this modifier should be used.
8. Modifier 81 - Minimum Assistant Surgeon: This modifier is applicable if a minimum assistant surgeon is involved in the procedure.
9. Modifier 82 - Assistant Surgeon (when qualified resident surgeon not available): Use this modifier when an assistant surgeon is necessary due to the unavailability of a qualified resident surgeon.
10. Modifier AS - Physician Assistant, Nurse Practitioner, or Clinical Nurse Specialist Services for Assistant at Surgery: This modifier is used when these non-physician practitioners assist in the surgery.
Each modifier should be used in accordance with the specific guidelines and payer requirements to ensure accurate billing and reimbursement.
The CPT code 58180 is reimbursed by Medicare, but the reimbursement is subject to several factors. The Medicare Physician Fee Schedule (MPFS) determines the payment rates for services covered under Medicare Part B, including surgical procedures like those represented by CPT code 58180. However, the actual reimbursement can vary based on geographic location and other considerations, as determined by the local Medicare Administrative Contractor (MAC). Each MAC has the authority to interpret national Medicare policies and apply them to local circumstances, which can affect the reimbursement rate for CPT code 58180. Therefore, healthcare providers should consult the MPFS and their specific MAC for the most accurate and up-to-date reimbursement information for this code.
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