A patient presented for a vaginal natural orifice transluminal endoscopic surgery (vNOTES) hysterectomy with bilateral salpingectomy. Following anterior and posterior colpotomies, a single port laparoscopic system was inserted through the vagina and pneumoperitoneum was established. The broad ligaments and utero-ovarian ligaments were coagulated and cut. Mesosalpinx on each side were clamped, the laparoscopic system was removed and the specimen sent to pathology. How is a vNOTES hysterectomy that combines vaginal and laparoscopic techniques without abdominal skin incisions coded?
When assigning a code for a vNOTES hysterectomy, select a code from the CPT code range 58260-58294 that captures the vaginal hysterectomy based on what was performed during the surgical encounter and the weight of the uterus. Although a laparoscopic device was utilized, the hysterectomy was still performed vaginally.
In a vNOTES hysterectomy, a laparoscopic device is inserted via incisions made in the vagina. The device inflates the abdomen with carbon dioxide, similar to a laparoscopic procedure, however there are no abdominal incisions. A high-definition camera and surgical instruments are inserted through the device to perform the hysterectomy.