Summary & Overview
CPT 58520: Repair of Ruptured or Lacerated Uterus
CPT code 58520 denotes surgical repair of a ruptured or lacerated uterus unrelated to childbirth, covering tears from procedures such as dilation and curettage or hysteroscopy, or from trauma. Nationally, this code captures episodic operative care in gynecology and is used across inpatient and ambulatory surgical settings where urgent or planned uterine repair is required. It matters because accurate coding affects clinical documentation, surgical quality tracking, and appropriate payment for gynecologic operative services.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find clinical context for when CPT code 58520 is applicable, typical sites of service, and an outline of common modifiers associated with surgical circumstances. The publication highlights benchmarks and coding practice considerations relevant to hospital and ambulatory surgery workflows, and summarizes policy updates that affect national billing and reimbursement for operative gynecologic procedures. The content is intended for billing professionals, clinical coders, compliance officers, and surgical teams seeking clarity on code use, service setting implications, and payer coverage patterns.
Billing Code Overview
CPT code 58520 describes surgical repair of a ruptured or lacerated uterus when the injury is not related to childbirth. This procedure addresses uterine tears that may occur as a complication of gynecologic procedures such as dilation and curettage (D & C) or hysteroscopic interventions, or from accidental injury.
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Service type: Surgical repair of uterine laceration (operative gynecologic procedure)
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Typical site of service: Inpatient or outpatient surgical setting, including operating room or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 38-year-old woman presents to the emergency department after acute lower abdominal pain and vaginal bleeding following an operative hysteroscopy performed earlier the same day. Imaging and exam suggest a full-thickness uterine laceration with hemoperitoneum. The gynecologic surgeon schedules an urgent operative repair of the ruptured uterus under general anesthesia. In the operating room the surgeon performs exploratory laparoscopy converted to laparotomy due to active bleeding, identifies the uterine tear near the fundus, evacuates blood and clots, irrigates the peritoneal cavity, and sutures the laceration in multiple layers to restore uterine integrity. Postoperative monitoring includes hemodynamic stabilization, serial hemoglobin checks, and counseling regarding future pregnancy risks.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work, time, or complexity substantially exceeds typical for 58520 (documentation required). |
23 | Unusual anesthesia | Use when a medically necessary but typically avoidable anesthesia is given for the procedure. |