AAPC - Back to school
Results 1 to 2 of 2

Thread: uterosacral ligament plication

  1. #1

    Default uterosacral ligament plication

    AAPC: Back to School
    We are billing for Laparoscopic Hysterectomy and our provider wants to know if he can also bill for what he describes as a Uterosacral Ligament Plication. I am unable to locate a specific code, closest I can find is 57423 and 57425. Any helps is appreciated!

  2. #2


    What was the diagnosis and indication for hysterectomy. If you had given the op note it would have been better.
    The doctor would have done the plication of the uterosacral ligament when he has the diagnosis of Prolapse uterus with rectocele /enterocele.
    So when there was a prolapse diagnosis (along with the reason for hysterectomy), there are two surgery at hand for him to decide-1. An Obliterative Surgery or 2. A Reconstrcutive Surgery. When he intended for reconstructive surgery to restore the normal anatomy and give the best chance for normal quality of life along with Hysterctomy,- restoration of the support to the vaginal apex is needed - either one of these common procedures that can do this job are : the Plication (fixation) of uterosacral ligament, Sacral colpopexy, Sacrospinous ligament fixation.
    So I would go for Hysterectomy code and vaginal apex restoration code 57425.
    Hysterctomy code alone is not sufficient to address the amount of work done by the surgeon.
    Our hysterectomy code sets are not addressing many of the work done along with, by the surgeons , laparoscopic in particular.
    So in short : if the surgeon did an OBLITERATIVE surgery along with hysterectomy - Hystectomy code alone would be enough . If he did a RECONSTRUCTIVE SURGERY ( what he has done now here), along with Hysterctomy code, I would report 57425 also.
    The surgeon’s diagnosis and the intended RECONSTRUCTIVE SURGERY should be documented in his report / or operative note clearly.

    Note: Uterosacral ligament placation/ colpopexy can be undertaken with or with out intended hysterectomy . There need not always be a hysterectomy to be accompanied.

    I do not know how the payers do. This is all about the medical necessity and the risk adjustments concepts I brought forth.
    Thank you.

Similar Threads

  1. Lap Uterosacral ligament Colposuspesnion
    By catharine in forum OB/GYN
    Replies: 0
    Last Post: 12-10-2015, 11:47 AM
  2. release uterosacral ligament
    By epwjfh in forum OB/GYN
    Replies: 0
    Last Post: 10-20-2014, 07:10 AM
  3. I am in need of a CPT code
    By tondan777 in forum OB/GYN
    Replies: 4
    Last Post: 03-13-2014, 04:55 AM
  4. Replies: 5
    Last Post: 03-12-2014, 09:16 PM
  5. Replies: 0
    Last Post: 03-07-2012, 11:38 AM

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts

Enjoying Our Forums?

AAPC forums are a benefit of membership. Joining AAPC grants you unlimited access, allowing you to post questions and participate with our community of over 150,000 professionals.

Join Now Continue Reading Without Full Access

Already a Member?


Close Message

In addition to full participation on AAPC forums, as a member you will be able to:

  • Access to the largest healthcare job database in the world.
  • Join over 150,000 members of the healthcare network in the world.
  • Be a part of an industry leading organization that drives the business side of healthcare.
  • Save anywhere from 10%-50% with exclusive member discounts on courses, books, study materials, and conferences.
  • Access to discounts at hundreds of restaurants, travel destinations, retail stores, and service providers. AAPC members also have opportunities to save on heath, life, and liability insurance.
  • Become a member of a local chapter and attend regular meetings.