Summary & Overview
CPT 58956: Abdominal Hysterectomy with Bilateral Salpingo-Oophorectomy and Omentectomy
CPT code 58956 denotes an extensive open abdominal oncologic procedure that removes the uterus, cervix, both ovaries and fallopian tubes, and the entire omentum. It is used when comprehensive surgical resection is required for gynecologic malignancy involving ovarian, uterine, or peritoneal spread. As a high-acuity, resource-intensive operation, this code is central to hospital surgical oncology billing and influences inpatient surgical utilization and reimbursement patterns nationally.
Payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication outlines coverage and payment considerations across these major payers and summarizes common billing modifiers associated with complex surgical procedures.
Readers will find a concise clinical context for the procedure, typical site-of-service considerations, and the coding relationships that affect claim submission and inpatient billing lines. The report highlights benchmark metrics, common payer policies relevant to major abdominal oncologic procedures, and areas where clinical documentation and coding specificity are most consequential for accurate claim processing. Data not available in the input are noted where applicable.
Billing Code Overview
CPT code 58956 describes an extensive surgical procedure performed for cancer in which the surgeon removes the uterus and cervix, both ovaries and fallopian tubes, and the entire omentum through an abdominal incision. This is a combined procedure addressing gynecologic organs and the omentum, typically undertaken for malignant disease requiring wide surgical clearance.
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Service type: Major open surgical oncology procedure (abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy)
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Typical site of service: Inpatient hospital surgical setting, performed in an operating room via an abdominal incision
Clinical & Coding Specifications
Clinical Context
A typical patient is a 58-year-old woman with high-grade ovarian carcinoma presenting with abdominal pain, bloating, early satiety, and increasing abdominal girth. Preoperative workup includes pelvic imaging (CT or transvaginal ultrasound), elevated CA-125, and multidisciplinary tumor board consensus for primary cytoreductive surgery. The surgical team performs an exploratory laparotomy via a midline abdominal incision, proceeds with total abdominal hysterectomy and bilateral salpingo-oophorectomy for removal of the primary gynecologic malignancy, then completes an omentectomy (removal of the entire omentum) to achieve cytoreduction and staging. Intraoperative steps include abdominal entry, thorough inspection of peritoneal surfaces, mobilization of the uterus, cervix, ovaries and fallopian tubes, ligation of vascular pedicles, removal of the uterus and adnexa, and resection of the greater omentum. Estimated blood loss, specimen labeling for pathology, and appropriate drains are documented. Typical perioperative workflow includes preoperative consent discussing oncologic resection, general anesthesia with appropriate monitoring, prophylactic antibiotics, venous thromboembolism prophylaxis, and postoperative admission for pain control, bowel function monitoring, and initiation of adjuvant therapy planning as indicated by final pathology.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Unspecified; not used for reimbursement modifiers | Data not used for billing clarification |