Ob-Gyn Coding Alert

Question: I have a provider that performed a 58263 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele), 57260 (Combined anteroposterior colporrhaphy…), and a “Uterosacral Ligament Plication with Vaginal Suspension.” What I should bill for the last procedure?

I have come up with a few different codes, but I’m not sure whether they are correct. Should I report 57283 (Colpopexy,vaginal; intra-peritoneal approach…) or 57425 (Laparoscopy, surgical, colpopexy…)?

Any advice?

Texas Subscriber

Answer: First of all, codes 58263 and 57260 are bundled procedures, because you have a more complete code that includes both the anterior/posterior repairs and an enterocele repair. This code is 57265 (Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed; with enterocele repair).

The best coding practice here would be 58262 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)) and 57265.

You should not use CPT^® code 57425 to report routine reattachment of the uterosacral ligaments to the vaginal cuff after completion of hysterectomy. This is considered a routine component of the hysterectomy procedure. This means you cannot separately code it.