Cpt code 58263. The CPT terminology is the most widely .

Cpt code 58263. org NOTE: The information listed here is not all-inclusive and is to be used as a reference only. See IHCP Bulletins and IHCP Fee Schedules for updates to coding, coverage and benefit information. This article provides guidance on these new guidelines and Aug 15, 2025 · More than 11,000 Current Procedural Terminology (CPT®) codes today serve as the standard medical code set terminology for communicating medical, surgical and diagnostic utilization across health care. Balt completed a vaginal hysterectomy to repair an enterocele. The CPT is a uniform coding system consisting of descriptive terms and identifying codes that are used primarily to identify medical services and procedures furnished by physicians and other health care professionals. What is the code for this procedure, and can it be charged in addition to vaginal hysterectomy? Dana Marcos Accounts/Receivable Coder, Mo. Each year, updates to the CPT® codes are made to reflect advancements in medical procedures Don’t let these 2025 CPT code changes come as a surprise in January. Anesthesia: General Procedure: Second-degree burn excision with skin grafting for TBSA of 8% Enter code: 01951 41. Apr 29, 2009 · Does anyone know where I can find a list that is CPT code specific for the AS modifer? Medicare is denying CPT codes 58263, 57260 and 57288 stating that AS modifier is not allowed with this code. May 28, 2015 · An exception to this rule is when the surgeon performs, and bills for, a vaginal hysterectomy code that includes enterocele repair, such as 58263. Similarly, all CPT, ICD-10 and HCPCS codes are supplied for informational purposes only and represent no statement, promise, or guarantee by Ethicon that Learn about billing and claims payment policies, evaluation and management services, and in-office lab and radiology codes. When can a modifier be used? Applicable Codes The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. Aug 19, 2024 · CPT® Codes Lookup Current Procedural Terminology, more commonly known as CPT®, refers to a medical code set created and maintained by the American Medical Association — and used by physicians, allied health professionals, nonphysician practitioners, hospitals, outpatient facilities, and laboratories to represent the services and procedures 6 days ago · Review the criteria for CPT® Category I, Category II and Category II codes, access applications and read frequently asked questions. Listing of a code in this policy does not imply that the service described by the code is a covered or non-covered health service. cms. Jun 27, 2025 · The Current Procedural Terminology (CPT®) codes offer doctors and health care professionals a uniform language for coding medical services and procedures to streamline reporting, increase accuracy and efficiency. , CPT code 58263 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s), with repair of Jan 1, 2024 · Obstetrical and Gynecological Services Codes Note: Due to possible changes in Indiana Health Coverage Programs (IHCP) policy or national coding updates, inclusion of a code on the code tables does not necessarily indicate current coverage. What are the Most Important CPT Modifiers for Medical Coding? Our community brings together students, educators, and subject enthusiasts in an online study community. The Current Procedural Terminology (CPT ®) code 58210 as maintained by American Medical Association, is a medical procedural code under the range - Hysterectomy Procedures. The payor is indicating 57250 59 is included with 58263. ncqa. Jan 1, 2024 · CPT and HCPCS Level II codes define medical and surgical procedures performed on patients. Some procedure codes are very specific in defining a single service (e. g. Using the CPT manual, select the correct anesthesia code. NOTE: The information listed here is not all-inclusive and is to be used as a reference only. Coding Reference Guide Measurement Year 2024 Cervical Cancer Screening (CCS) Measure Description Members 21-64 years of age who were recommended for routine cervical cancer screening and were screened using any of the following criteria: Aug 19, 2024 · The Current Procedural Terminology (CPT) code range for Hysterectomy Procedures 58150-58294 is a medical code set maintained by the American Medical Association. Aug 21, 2020 · To gain the greatest sensitivity for CPT coding of cystoscopy, we included all the CPT codes encompassing endoscopy of the bladder (Table). Please refer to current ICD-10/CPT®/HCPCS coding and documentation guidelines at www. gov. Some procedure codes are very specific defining a single service (e. My claim was rejected for payment. These 17 new codes are intended for reporting synchronous (ie, real-time) E/M services, with coding options available for both new and established patients. Q I need CPT codes for the following surgical procedures performed on 1 patient on the same day: transvaginal hysterectomy, anterior pelvic floor reconstruction with Pelvicol graft tissue, posterior colporrhaphy, enterocele repair, and a bilateral vaginal vault suspension with the IVS tunneler system. Users of this code set should obtain all necessary licenses. Oct 2, 2025 · Coders will be relieved to see one section relatively untouched for the first time in years. The CPT code specific to this procedure would be 58262. Oct 3, 2025 · The Current Procedural Terminology (CPT®) code set is a listing of descriptive terms and five-digit codes for reporting medical services and procedures performed by physicians and other qualified health care professionals. Code 57280 Nov 9, 2023 · The student is asking for the correct **Current Procedural Terminology ** (CPT) code for a specific medical procedure. The UB Codes contained in the HEDIS specifications may be used by health plans and other health care delivery organizations for the purpose of calculating and reporting HEDIS results or using HEDIS measure results for their internal quality improvement purposes. What is the appropriate CPT code for this procedure? a) 58260 b) 58262 c) 58263 d) 58270 mesh code 57267 may be used only with codes 45560 or 57240 to 57265. This code represents a ' Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele. 99242 c. Jan 1, 2025 · Or, call 866-889-8054. 99231 d. Dr. Sep 11, 2025 · Find a variety of coding books, search tools and databases for billing outpatient & office procedures. How To Use CPT Code 57105 This Content Might Be Outdated - Check in Our Free Code Lookup Tool Medical codes change frequently, and using outdated information can lead to denials. The Current Procedural Terminology (CPT ®) code 57282 as maintained by American Medical Association, is a medical procedural code under the range - Repair Procedures on the Vagina. Note that in 2003, the CPT code choices will change. Remove deleted or invalid codes 58593 and 58551 from PA grid. Dec 2, 2024 · Don’t let these code changes come as a surprise in January. Ensure you're working with the most up-to-date version of CPT Code 57105 by opening it in our free code lookup tool. Aug 19, 2024 · CPT® Codes Lookup Current Procedural Terminology, more commonly known as CPT®, refers to a medical code set created and maintained by the American Medical Association — and used by physicians, allied health professionals, nonphysician practitioners, hospitals, outpatient facilities, and laboratories to represent the services and procedures 6 days ago · Review the criteria for CPT® Category I, Category II and Category II codes, access applications and read frequently asked questions. Jan 10, 2024 · The correct CPT code for a vaginal hysterectomy with repair of an enterocele, with a uterus weighing 237 grams, is 58260. Removed code 58548 from policy, it will be managed in MPM 16. Feb 28, 2025 · HCPCS Level II and CPT codes define medical and surgical procedures performed on patients. ICD-9-CM is the International Classification of Diseases - 9th Revision - Clinical Modification Coding System. The calendar year (CY) 2026 update to the American Medical CPT® 2026 code set includes hundreds of new, revised, or deleted codes for reporting medical services and procedures. For the Current Procedural Technology (CPT®) 2025 code set, a new Telemedicine Services subsection with 17 new codes has been added to the Evaluation and Management (E/M) section. Feb 1, 2024 · Dr. 10 and continue no PA requirement. org What are the Most Important CPT Modifiers for Medical Coding? In a September 2007 supplement to OBG Management, “Best options, techniques, and coding tips for pelvic pro-lapse repair,” I answered frequently asked questions about Current Procedural Terminology (CPT) codes and documen-tation for these procedures. All other uses of the UB Codes require a license from the AHA. For more details and the CPT codes that require prior authorization, please see Radiology Prior Authorization and Notification. Specifically, Dr. CPT codes are also used for administrative management purposes such as claims processing and developing guidelines for medical care review. Total Hysterectomy, bilateral salpingectomy, McCall's culdoplasty, posterior wall repair and cystoscopy - I'm biling CPT 58263, 57250 59 and 52000 59. Apr 1, 2000 · Question: The physician performed a simple vaginal vault suspension at the time of a vaginal hysterectomy. Applicable Codes The following list(s) of procedure and/or diagnosis codes is provided for reference purposes only and may not be all inclusive. . In this follow-up supplement, I explain a number of changes to those codes that have occurred in the interim and that appear in the CPT 2010 2020 Hysterectomy Reimbursement Fact The information contained in this document is provided for informational purposes only and represents no statement, promise, or guarantee by Ethicon concerning levels of reimbursement, payment, or charge. In addition, we identified concomitant midurethral sling (MUS) procedures, because these are frequently performed during pelvic reconstructive surgery and routinely include cystoscopy. These codes define how health care is delivered and measured, and enable the exchange of information in a data-driven health system. Balt completed a vaginal hysterectomy with repair of an enterocele. Jan 1, 2003 · Code 58270 includes the hysterectomy, the perineorrhaphy, and the McCall culdoplasty, and 57260 covers the anteroposterior repair. , CPT code 58263 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s) with repair of Feb 9, 2024 · a. For Vaginal Hysterectomy: Continue following MCG S -660 and continue PA requirement for codes 58260, 58262, 58263, 58267, 58270, 58275, 58280, 58294, 58290, 58291, and 58292. Jan 1, 2024 · The CPT and HCPCS Level II codes define medical and surgical procedures performed on patients. As a uniform language and widely accepted medical nomenclature, CPT codes enable stakeholders across the health care ecosystem to document, communicate and understand the 6 days ago · Current Procedural Terminology (CPT®) codes provide a uniform nomenclature for coding medical procedures and services. Answer: A vaginal vault suspension is described by more than one CPT code, depending on the approach and where the suspension was anchored. The report clearly indicates posterior vaginal wall HCPCS Level II codes are additional codes created and maintained by Centers for Medicare & Medicaid Services (CMS). The pathology report stated the uterus weighed 237 grams. The CPT terminology is the most widely Oct 3, 2025 · The Current Procedural Terminology (CPT®) code set is a listing of descriptive terms and five-digit codes for reporting medical services and procedures performed by physicians and other qualified health care professionals. Benefit coverage for health services is determined by federal, state, or contractual requirements and applicable laws Limited proprietary coding from Current Procedural Terminology (CPT®) is contained in the measure specifications. AUGS disclaims all liability for use or accuracy of any Current Procedural Terminology (CPT®) or other coding contained in the specifications. For an enterocele repair with the vaginal hysterectomy (code 58263), intraperitoneal-approach colpopexy, co CPT Codes for Female Pelvic Organ Prolapse Procedures and Procedure Types. , CPT code 93000 (electrocardiogram)), while other codes define procedures consisting of many services (e. ' Please remember that pathology Enter the ICD-9-CM diagnosis code that represents the condition or symptom of the client that establishes the need for the service requested. Online medical coding solutions: Codify by AAPC easy CPT®, HCPCS, & ICD-10 lookup, plus crosswalks, CCI, MPFS, specialty coding publications & webinars. CPT code 58270 is used for a vaginal hysterectomy procedure involving the removal of a uterus weighing 250 grams or less, including enterocele repair. Here you'll find the AMA's latest updates on new CPT codes, new code proposals, CPT code revisions and more. 99239. In these circumstances, the combined colporrhaphy remains bundled with the vaginal hysterectomy, unless a special modifier is used. This article provides guidance on these new guidelines and Sep 11, 2025 · The CPT code set allows for the seamless flow of complex medical information across the entire health system and has a foundational role in research, analysis, and benchmarking of health care services and outcomes that promotes the delivery of high-quality care,” said AMA President-elect Willie Underwood, III, MD, MSc, MPH. Reimbursement Policies Learn about billing and claims payment policies, evaluation and management services, and in-office lab and radiology codes. , CPT code 58263 (Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s), with repair of The Current Procedural Terminology (CPT ®) code 58291 as maintained by American Medical Association, is a medical procedural code under the range - Hysterectomy Procedures. Aug 15, 2025 · More than 11,000 Current Procedural Terminology (CPT®) codes today serve as the standard medical code set terminology for communicating medical, surgical and diagnostic utilization across health care. 99255 40. , CPT code 93000 (electrocardiogram)) while other codes define procedures consisting of many services (e. With around-the-clock expert help, you can find the help you need, whenever you need it. HEDIS® measures can be found at www. aszm eyx dse cbrzhm nrxa po vnuxfyp ejjadsv lu6 4sx5a