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Ob-Gyn Coding Alert

Reader Questions:

Highlight These Three LAVH, TLH Differences

Published on Sun Jul 25, 2010

Question: What is the difference between 58550 (laparoscopy with vaginal hysterectomy or LAVH) and 58570 (total laparoscopic hysterectomy or TLH)? I always thought that with the LAVH, the ob-gyn pulled out the uterus vaginally after he cut the ligaments through the scope. With the TLH, the ob-gyn cut the uterus with a morcellator and pulled out in pieces through the scope. A couple of physicians I code for are labeling their surgeries TLH's and wanting to bill 58570, but reading the op reports I see that they pulled the uterus out vaginally in one piece. What should I tell them?Oregon SubscriberAnswer:For a total laparoscopic hysterectomy (TLH), the ob-gyn can remove the uterus via the scope or vaginally in one piece.  What makes the difference is how the ob-gyn severs the connections and how the ob-gyn sews the vaginal cuff.Difference 1: In the laparoscopic with vaginal hysterectomy (LAVH) cases, the ob-gyn severs only the [...]
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