Gynecology CPT Codes: Essential Updates for 2025

Billing errors, obsolete codes, and uneven reimbursement remain key issues in gynecological practice management. As procedures change and digital healthcare expands, utilizing out-of-date CPT codes raises the risk of claim denials and compliance difficulties. Are you sure your billing processes will reflect the most recent CPT modifications affecting gynecology in 2025?

Several significant changes to the CPT code system were implemented in 2025, directly influencing gynecological billing. These include 17 new telemedicine E/M codes for remote consultations (AAPC), seven new Category III codes for artificial intelligence-assisted diagnostics and treatments (AMA), and expanded definitions in Remote Therapeutic Monitoring (RTM) codes 98975-98978 to include digital interventions (Wolters Kluwer). Additionally, new codes for Skin Cell Suspension Autograft (SCSA) procedures (15011–15018) and updated codes for intra-abdominal tumor or cyst removals aim to improve precision in surgical billing.

These modifications reflect the transition to digital health, AI integration, and more specific reporting criteria in gynecological care. This article delves into each upgrade, demonstrating how to use these improvements to maintain compliance, minimize rejections, and enhance revenue cycle performance in 2025.

More About Gynecology CPT Codes

This section defines Gynecology CPT Codes and explains their significance in clinical and billing procedures. It lays the groundwork for healthcare providers who want consistent, updated coding to ensure correct claims and compliance.

What Are Gynecology CPT Codes?

Gynecology CPT Codes are standardized number codes used to indicate medical, surgical, diagnostic, and evaluative services related to women’s reproductive health. The American Medical Association (AMA) issues and updates these codes annually.

They provide services such as pelvic examinations, hysteroscopies, biopsies, contraception, and gynecologic operations. Examples are 58150 (Total abdominal hysterectomy), 58300 (Insertion of intrauterine device), and 76830 (Transvaginal ultrasound).

Each code is essential for accurately charging payers, establishing the medical necessity of a treatment, and ensuring that reimbursement is neither delayed nor refused. Using obsolete or erroneous codes can lead to denial claims, compliance audits, and revenue loss.

Why Are Gynecology CPT Codes Important?

These codes affect reimbursement, compliance, and clinical documentation. For gynecologists, OB/GYN billers, and revenue cycle teams, coding accuracy immediately impacts how a surgery is reported and paid for.

Using the correct CPT codes also ensures compliance with payer-specific rules. Incorrect usage may result in claim rejections, payment delays, or regulatory investigations. For example, 58957 with tumor reduction in 2025 is no longer acceptable; it has been superseded with size-based codes such as 49186-49190.

Accurate use of Gynecology CPT Codes promotes clinical and practical integrity. For practices, this leads to fewer appeals and improved revenue cycle performance.

Key Updates in Gynecology CPT Codes for 2025

This section describes the key changes in the 2025 CPT code set that affect gynecological procedures.

1. Telemedicine Services:

17 New E/M Codes: Added for audio-video and audio-only consultations to improve documentation and reimbursement for remote patient contacts.

2. Artificial Intelligence (AI) Integration:

Seven New Category III Codes: AI medical services and processes are classified as assistive, augmentative, or autonomous, which improves the specificity of AI-driven diagnosis and therapies.

3. Remote Therapeutic Monitoring (RTM)

Revisions to RTM Codes 98975–98978: Now include digital therapeutic interventions and device supply for data access or transmission, reflecting the growing role of digital health tools in patient care.

4. Skin Cell Suspension Autograft (SCSA)

Introduction of Codes 15011–15018: Allows for more precise reporting of skin grafting techniques, particularly in burn and trauma care.

5. General Surgery Updates

New Codes for Intra-abdominal: Add for tumors or cysts, including those related to gynecologic malignancies, aims to improve coding accuracy for surgical procedures.

Common CPT Codes for Gynecology

Accurate coding is required for effective billing, compliance, and reimbursement in gynecological treatments. This section lists widely used CPT Codes in gynecology, categorized for clarity.

OB/GYN Consultation and Examination Codes

CPT Code	Description
99202–99205	Office or outpatient visit for new patients (based on complexity and time).
99211–99215	Office or outpatient visit for established patients (based on complexity).
99394–99397	Preventive visits for established patients (ages 12 through 65+).
57410	Pelvic and breast exam during initial gynecologic evaluation.
57420	Preventive gynecological examination (non-problem focused).

Diagnostic and Imaging Codes in Gynecology

CPT Code	Description
76830	Transvaginal pelvic ultrasound.
76856	Pelvic ultrasound, non-obstetric, complete.
88141	Cytopathology, cervical or vaginal (Pap smear), interpretation by physician.
88175	Automated thin-layer Pap test with manual rescreening if needed.
58100	Endometrial biopsy without cervical dilation.
58340	Catheterization and introduction of saline or contrast for sonohysterography.

Surgical Codes for Gynecology Procedures

CPT Code	Description
58120	Dilation and curettage (D&C) for diagnostic or therapeutic purposes.
57500	Cervical biopsy, single or multiple.
58180	Suction aspiration (e.g., for incomplete or missed abortion).
58661	Laparoscopy with removal of adnexal structures (ovary, fallopian tube, or both).
58150	Total abdominal hysterectomy (including uterus, cervix).
57425	Colposcopy of the cervix with loop electrode conization.

Common Modifiers for Gynecology

Modifiers explain procedures and avoid improper payments or denials. This section describes the key modifiers required with Gynecology CPT Codes to guarantee correct billing.

Frequently Used Gynecology Modifiers

Modifier	Description	Usage in Gynecology Billing
-25	Significant, separately identifiable E/M service by the same physician on the same day of a procedure	Used when a pelvic exam and a separate procedure (e.g., colposcopy) occur on the same day
-59	Distinct procedural service	Applied when two procedures are not typically reported together but are appropriate in certain clinical cases
-51	Multiple procedures	Used when multiple surgical procedures are performed during the same session
-76	Repeat the procedure or service by the same physician	Reported when a diagnostic procedure, like an ultrasound, is repeated on the same day
-77	Repeat the procedure by another physician.	It can be used when a diagnostic test (e.g., hysteroscopy) is repeated by another practitioner.
-26	Professional component	Required for services like ultrasound, where the physician only interprets the test
-TC	Technical component	Used when billing for the equipment and technical aspect of diagnostic services
-GA	Waiver of liability statement issued	Required when billing a service expected to be denied and the patient has signed an ABN (Advance Beneficiary Notice)

Tips for Revenue Cycle Management in Gynecology

Applying the appropriate coding techniques is the first step toward improving billing accuracy and reducing payment delays. This section highlights critical focus areas to assist gynecological clinics in maintaining clean claims and sustainable cash flow.

Billing and Coding for Gynecology Surgeries

Use the appropriate CPT modifiers for bilateral procedures and numerous operations.

When submitting a claim, check that the diagnostic codes support the medical necessity.

To avoid conflicts, ensure that operational reports match billable procedures.

Use time-based codes appropriately during lengthy surgical procedures.

Working with Insurance Providers

Before performing elective treatments, verify your coverage and authorization.

Keep payer-specific restrictions for OB/GYN CPT codes in your billing system.

Track payer replies to identify rejection patterns for gynaecological services.

When payers request records, submit them immediately.

Conclusion

Staying up with the 2025 CPT code updates is critical for correct gynecological billing. The combined effect of digital health, artificial intelligence, and new procedure definitions necessitates careful code selection. Using old or incorrect codes can lead to rejections, compliance reviews, and payment delays. Practices must prioritize proper modifier usage, clinical documentation alignment, and payer-specific coding standards. Routine audits and staff training are required to minimize mistakes and ensure reimbursement uniformity. Implementing these measures promotes consistent revenue cycle performance and reduces administrative difficulties.