Summary & Overview
CPT 58958: Debulking Surgery for Recurrent Gynecologic Malignancy
CPT code 58958 designates a major oncologic surgical procedure for recurrent gynecologic cancers—removal of disease from the ovaries, fallopian tubes, peritoneum, or uterus with omentectomy if necessary, along with pelvic lymphadenectomy and para‑aortic node sampling. This code captures complex cytoreductive or debulking operations that are central to management of recurrent ovarian and related malignancies and can drive substantial hospital resource use and postoperative care needs nationwide.
Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national perspective on clinical context, typical sites of service, common modifiers, and related reimbursement considerations. The publication provides benchmarks for utilization and allowed payment patterns where available, outlines relevant coding and documentation issues commonly encountered with extensive cytoreductive procedures, and highlights policy updates that affect coverage and claims processing for complex gynecologic oncology surgery.
This summary equips billing, coding, and clinical leaders with a concise reference to understand when 58958 applies, what components the code encompasses, and which payer policies and documentation elements most often influence claim outcomes and payment for major recurrent gynecologic cancer surgeries.
Billing Code Overview
CPT code 58958 describes a surgical procedure for the removal of recurrent gynecologic malignancy involving the ovaries, fallopian tubes, peritoneum, or uterus, with omentectomy performed if indicated. The procedure also includes removal of pelvic lymph nodes and sampling of para‑aortic lymph nodes as part of the same operative episode.
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Service type: Major operative oncology procedure (cytoreductive/debulking surgery for recurrent gynecologic cancer)
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Typical site of service: Hospital inpatient surgical setting; may also be performed in hospital outpatient or ambulatory surgery centers depending on clinical staging and complexity
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman with suspected or confirmed advanced epithelial ovarian carcinoma who presents with abdominal pain, bloating, early satiety, and imaging showing adnexal masses with possible peritoneal spread. The surgical team (gynecologic oncologist) performs an exploratory laparotomy or laparoscopy for definitive cytoreduction: removal of the uterus and adnexa as indicated, bilateral salpingo-oophorectomy if involved, omentectomy as necessary, formal pelvic lymphadenectomy, and sampling or dissection of para‑aortic lymph nodes. The workflow includes preoperative staging with CT or PET/CT, multidisciplinary tumor board review, informed consent, anesthesia evaluation, intraoperative frozen section when required, performance of maximal cytoreductive surgery to achieve no gross residual disease when feasible, placement of drains if indicated, and postoperative recovery with monitoring for complications (bleeding, infection, thromboembolism, bowel injury). Pathology processes the resected uterus, adnexa, omentum, and lymph nodes for definitive histology and nodal status to guide adjuvant chemotherapy planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no specific modifier applies and a single procedure is reported |
11 |