32 Hysterectomy Codes Removed from Prior Authorization List

51597

Pelvic exenteration, complete, for vesical, prostatic, or urethral malignancy, with removal of bladder and ureteral transplantations, with or without hysterectomy and/or abdominoperineal resection of rectum and colon and colostomy, or any combination thereof

58150

Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s)

58152

Total abdominal hysterectomy (corpus and cervix), with or without removal of tube(s), with or without removal of ovary(s); with colpo-urethrocystopexy (eg, Marshall-Marchetti-Krantz, Burch)

58180

Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of ovary(s)

58200

Total abdominal hysterectomy, including partial vaginectomy, with para-aortic and pelvic lymph node sampling, with or without removal of tube(s), with our without removal of ovary(s)

58210

Radical abdominal hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with or without removal of tube(s), with or without removal of ovary(s)

58260

Vaginal hysterectomy, for uterus 250 g or less

58262

Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s)

58263

Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s), with repair of enterocele

58267

Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, pereyra type) with or without endoscopic control

58270

Vaginal hysterectomy, for uterus 250 g or less; with repair of enterocele

58275

Vaginal hysterectomy, with total or partial vaginectomy

58280

Vaginal hysterectomy, with total or partial vaginectomy; with repair of enterocele

58285

Vaginal hysterectomy, radical (Schauta type operation)

58290

Vaginal hysterectomy, for uterus greater than 250 g

58291

Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

58292

Vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s), with repair of enterocele

58541

Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less

58542

Laparoscopy, surgical, supracervical hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)

58543

Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g

58544

Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

58548

Laparoscopy, surgical, with radical hysterectomy, with bilateral total pelvic lymphadenectomy and para-aortic lymph node sampling (biopsy), with removal of tube(s) and/or ovary(s), if performed

58550

Laparoscopy surgical, with vaginal hysterectomy, for uterus 250 g or less

58552

Laparoscopy surgical, with vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)

58553

Laparoscopy surgical, with vaginal hysterectomy, for uterus greater than 250 g

58554

Laparoscopy surgical, with vaginal hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

58570

Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less

58571

Laparoscopy, surgical, with total hysterectomy, for uterus 250 g or less; with removal of tube(s) and/or ovary(s)

58572

Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g

58573

Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

58575

Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed

59525

Subtotal or total hysterectomy after cesarean delivery (list separately in addition to code for primary procedure)