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2024 CPT Blog: Part 3

2024 CPT TRFA Updates

We continue our deep dive into the 2024 CPT changes this week with updates to the codes for Transcervical Radiofrequency Ablation of Uterine Fibroids (TRFA).

Category III code 0404T Transcervical uterine fibroid(s) ablation with ultrasound guidance, RF has been deleted and a new Category I code 58580 has been created for reporting transcervical RF ablation of uterine fibroid(s), including intraoperative ultrasound guidance and monitoring (see table below)..

Uterine fibroids, or leiomyomata, are benign growths (non-cancerous) in or around the uterus. Fibroids can range in size from a grape to larger than a grapefruit and may cause significant symptoms, including heavy menstrual bleeding, abdominal/pelvic pressure, subfertility, painful sex, constipation, and painful periods. These symptoms may worsen over time if the fibroids are left untreated. Fibroids are grouped by their location in the uterus. Intramural fibroids grow within the muscular wall of the uterus. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids form on the outside of the uterus.

There are several surgical treatments are available for removing or shrinking fibroids including myomectomy, hysterectomy, uterine artery embolization, laparoscopic RF ablation and transcervical RF ablation. Transcervical fibroid ablation, often performed using the Sonata System, is one of the newest tools in fibroid treatment. Transcervical fibroid ablation uses radiofrequency energy to destroy fibroid tissue, while preserving the uterus. Transcervical RF ablation is the only technique that requires no incision and has a recovery time of a few hours rather than days or weeks experienced in other surgical options. In addition, transcervical RF ablation can treat all types of fibroids, alleviates fibroid symptoms including heavy periods and preserves the patient’s ability to conceive.

Do not report 58580 in conjunction with:

  • 58561 Hysteroscopy, surgical; with removal of leiomyomata
  • 58674, Laparoscopy, surgical, ablation of uterine fibroid(s) including intraoperative ultrasound guidance and monitoring, radiofrequency
  • 76830 Ultrasound, transvaginal
  • 76940 Ultrasound guidance for and monitoring of parenchymal tissue ablation
  • 76998 Ultrasonic guidance intraoperative


Treatment — The White Dress Project

Uterine fibroids – Symptoms and causes – Mayo Clinic