CPT® Code 58559

The CPT® Code 58559 refers to a surgical procedure known as hysteroscopy with lysis of intrauterine adhesions. This procedure is performed to address intrauterine adhesions, which are also known as synechiae or scar tissue. These adhesions can form within the uterine cavity and may lead to complications such as infertility, abnormal menstrual bleeding, or other reproductive issues. The procedure begins with a thorough bimanual pelvic examination to assess the condition of the uterus and surrounding structures. Following this, a single-tooth tenaculum is applied to the anterior cervical lip to stabilize the cervix during the procedure. A sound is then introduced to measure the depth and angle of the uterus, ensuring proper placement of the hysteroscope. To facilitate the insertion of the hysteroscope, the cervix is numbed and dilated using metal dilators. The hysteroscope is then carefully inserted into the endocervical canal and advanced into the uterine cavity under direct visualization, while the uterus is simultaneously expanded using saline or carbon dioxide. This expansion allows for a clear view of the uterine lining and any existing adhesions or intrauterine septum. The primary goal of the procedure is to identify and lyse the intrauterine adhesions, which can be accomplished through various methods such as blunt dissection, scissors, or laser techniques. Once the adhesions are successfully removed, the tubal openings, or ostia, are visualized to ensure they are clear. Finally, all surgical instruments, including the hysteroscope, are withdrawn, and the tenaculum is removed from the cervical lip. Any bleeding from the cervix is managed through the application of pressure, concluding the procedure.