# Lap Hysterectomy



## glenmrtn1 (Nov 2, 2010)

Can someone tell me when its apporpiate to use the 58550 versus the 58553. The doctor starts the procedure by putting all lap instruments and proceeds to do all his cutting etc. He then deliveries the contents via the vagina. Which code is it. What is the key word between both codes. I thought that all contents needed to me morcellated and delivered by lap bag. Please help.

Thanks


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## bonzaibex (Nov 2, 2010)

The only difference between the 2 codes is the weight of the uterus.  Code 58550 if uterus weighs 250g or less. Code 58553 if uterus weighs greater than 250g.  Neither code includes tubes &/or ovaries, so if the surgery includes removal of tube(s) and/or ovary(s), then use 58552 or 58554, depending on size of uterus.  

Becky, CPC


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## glenmrtn1 (Nov 3, 2010)

*Confusion*

I am aware of the difference. I must not have asked correctly what I am looking for. What I want to know is when is it appropiate to use the total lap hysterectomy code of 58570 instead of the lap assissted 58550. Does delivery of the uterus via the vagina support the 58550.

I hope I am making sense here.


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## gost (Nov 3, 2010)

In 58570, the uterus is morcellized and removed with lap tools.  In 58550, the uterus is removed via a vaginal incision.


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## preserene (Nov 3, 2010)

I  feel that Becky and Gost got the points.
Your first posting also makes us understand what you are looking for. 
58550- is for uterus  (body of the uterus and the cervix alone) wieghing 250grms or less;
58553 is for uterus  (body of th euterus an dthe crevix alone) more than 250 grms.
The KEY WORDs are: 1)  =/ more than, Or less than 250grms. 2).  common factor, is the UTERUS alone( which is body of the uterus and the cervix).
Whether it was removed as body and cervix separately or as in pieces, does not matter , weigh them all together or sum up the contents/parts of the uterus alone.

With the uterine tube(s) and ovary  have different codes.

The procedure is LAP and the doctor makes it in peice meals /or enmass, IT IS UTERINE REMOVAL and  the procedure is  Lap vaginal hysterectomy(LAP). The removal can  be through the lap bag or manual it does not matter in coding. ( it depends on the feasibilty and the convenience of the procedure in the hands of the surgeon) 
The mission ( the aim of the procedure and the procedure done) is all that it counts, not the method of removal of the excised organ or tissues.  THE MISSION ACCOMPLISHED!!

If your doctor HAD MORE TIME  AND ENERGY(WORK) SPENT ON IT BECAUSE OF DIFFICULTY, OR SOME REASON, you can consider for modifier 22


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