CPT code 58571 is for a laparoscopic surgery involving total hysterectomy for a uterus 250 g or less, including removal of tubes and/or ovaries.
CPT code 58571 is used to describe a laparoscopic surgical procedure that involves a total hysterectomy for a uterus weighing 250 grams or less. This procedure also includes the removal of one or both fallopian tubes and/or ovaries. The code is specific to minimally invasive surgery, where the surgeon uses a laparoscope to perform the operation, which typically results in smaller incisions, reduced recovery time, and less postoperative pain compared to traditional open surgery. This code is essential for healthcare providers to accurately document and bill for the procedure, ensuring appropriate reimbursement from insurance companies.
For CPT code 58571, 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 unusual anatomy or complications that arose during surgery.
2. Modifier 51 (Multiple Procedures): If multiple procedures are performed during the same surgical session, this modifier indicates that more than one procedure was conducted.
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): If the patient requires an unplanned return to the operating room for a related procedure during the postoperative period, this modifier is appropriate.
6. Modifier 79 (Unrelated Procedure or Service by the Same Physician During the Postoperative Period): This modifier is used when a procedure is performed during the postoperative period of another procedure, but is unrelated to the original procedure.
7. Modifier LT (Left Side) and RT (Right Side): These modifiers are used to specify the side of the body on which the procedure was performed, if applicable.
8. Modifier 24 (Unrelated Evaluation and Management Service by the Same Physician During a Postoperative Period): If an evaluation and management service is performed during the postoperative period of another procedure, and it is unrelated to the recovery from the surgical procedure, this modifier is used.
Each modifier should be applied based on the specific details of the surgical procedure and the circumstances surrounding it. Proper documentation is essential to justify the use of any modifier.
CPT code 58571 is reimbursed by Medicare, but the reimbursement is subject to specific conditions and guidelines. The Medicare Physician Fee Schedule (MPFS) provides the reimbursement rates for services covered under Medicare Part B, including surgical procedures like those represented by CPT code 58571. The reimbursement amount can vary based on geographic location and other factors, as determined by the local Medicare Administrative Contractor (MAC). Each MAC is responsible for processing claims and setting local coverage determinations, which can influence whether a particular service is reimbursed and at what rate. Therefore, healthcare providers should consult the MPFS and their respective MAC for the most accurate and up-to-date information regarding reimbursement for CPT code 58571.
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