Summary & Overview
CPT 58560: Hysteroscopic Resection of Intrauterine Septum
CPT code 58560 represents hysteroscopic resection of an intrauterine septum, a minimally invasive gynecologic procedure to restore a single uterine cavity. This code is clinically significant for fertility management and abnormal uterine anatomy correction; it is performed under direct hysteroscopic visualization and commonly occurs in hospital outpatient departments and ambulatory surgery centers. Nationally, accurate coding and documentation for this procedure affect surgical scheduling, claims adjudication, and patient access to restorative gynecologic care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes common payment and billing considerations across major payers, highlights coding nuances for hysteroscopic procedures, and outlines where clinical documentation supports procedure selection.
Readers will learn practical benchmarks and context for CPT code 58560: the clinical intent of the service, typical sites of service, expected documentation elements that support medical necessity, and common payer coverage patterns. The summary also notes where input data was not available for specific fields such as associated taxonomies, ICD-10 diagnoses, and related codes. This national overview is intended to inform billing staff, practice managers, and policy analysts about the coding and clinical context of hysteroscopic septum resection.
Billing Code Overview
CPT code 58560 describes a hysteroscopic procedure to remove an intrauterine septum or band of tissue that divides the uterine cavity, restoring the uterus to a single cavity. The procedure is performed using a hysteroscope inserted into the uterine cavity to visualize and transect the septum.
-
Service type: Minimally invasive gynecologic surgery (hysteroscopic septum resection)
-
Typical site of service: Hospital outpatient department or ambulatory surgery center
Clinical & Coding Specifications
Clinical Context
A 32-year-old woman with a history of recurrent first-trimester pregnancy loss and infertility undergoes evaluation with hysterosalpingography and diagnostic hysteroscopy, which demonstrate an intrauterine septum dividing the uterine cavity. After counseling, the patient is scheduled for operative hysteroscopic metroplasty. Under general anesthesia in an ambulatory surgery center, a gynecologic surgeon inserts a hysteroscope into the uterine cavity, visualizes the septum, and uses hysteroscopic scissors or resectoscope to incise and remove the septal tissue until a single uterine cavity is restored. The procedure typically includes intraoperative uterine distention, fluid management, possible electrosurgical tissue removal, and hemostasis. Postprocedure, the patient is observed for recovery from anesthesia and monitored for vaginal bleeding, fluid overload, and signs of infection before discharge the same day. Follow-up includes postoperative imaging or hysteroscopy as clinically indicated to confirm a single cavity and counseling regarding contraception or timing of future conception.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds that typically required for 58560 (document specifics). |