How To Use CPT Code 58670

CPT 58670 is a surgical procedure code for laparoscopic fulguration of oviducts, which is used to prevent pregnancy. This article will cover the description, procedure, qualifying circumstances, billing guidelines, documentation requirements, historical information, similar codes, and examples of CPT 58670.

1. What is CPT 58670?

CPT 58670 is a medical procedure code used to describe a laparoscopic surgical intervention involving the fulguration (sealing off) of the oviducts (fallopian tubes) with or without transection (cutting in half) to prevent pregnancy. This code is used by medical coders and billers to accurately document and bill for this specific procedure.

2. 58670 CPT code description

The official description of CPT code 58670 is: “Laparoscopy, surgical; with fulguration of oviducts (with or without transection)”.

3. Procedure

  1. The patient is placed in the dorsal lithotomy position.
  2. The abdomen is prepped and draped, and general anesthesia is administered.
  3. A uterine manipulator is placed through the cervix to move the uterus during surgery.
  4. The provider enters the abdominal cavity near the belly button using a Veress needle or an open incision and places a laparoscope.
  5. The abdomen is insufflated with CO2 gas to create a pneumoperitoneum, and the patient is put into the Trendelenburg position.
  6. Small incisions are made around the abdominal area to insert trocars for better visualization and insertion of surgical tools.
  7. If robotic surgery is being performed, the robot is docked to the laparoscope at this time.
  8. Each fallopian tube is identified and traced to its fimbriated end.
  9. High-frequency electric current is applied to the middle of each tube to seal it off; the tube may be cut at the cauterized site.
  10. A portion of the fallopian tube may be removed for pathology.
  11. The abdominal cavity is irrigated and deflated, and all instruments and trocars are removed.
  12. The trocar site fascia and skin are closed, and all instruments are removed from the vagina.

4. Qualifying circumstances

Patients eligible to receive CPT 58670 services are those who have decided to undergo permanent sterilization to prevent pregnancy. This procedure is typically performed on women who have completed their family planning or have medical conditions that make pregnancy risky. It is essential for the patient to understand the permanent nature of this procedure and provide informed consent before undergoing the surgery.

5. When to use CPT code 58670

CPT code 58670 should be used when a provider performs a laparoscopic surgical procedure involving the fulguration of oviducts to prevent pregnancy. This code is appropriate for billing when the procedure is performed as described and meets the qualifying circumstances mentioned above.

6. Documentation requirements

To support a claim for CPT 58670, the following information should be documented in the patient’s medical record:

  • Indication for the procedure (e.g., permanent sterilization, medical contraindications to pregnancy)
  • Informed consent obtained from the patient
  • Details of the anesthesia administered
  • Step-by-step description of the procedure performed
  • Any complications encountered during the procedure
  • Postoperative care instructions and follow-up plan

7. Billing guidelines

When billing for CPT 58670, it is essential to follow the appropriate guidelines and rules. If the provider only fulgurates one tube, a modifier 52 (Reduced services) should be added to 58670. Additionally, ensure that the documentation requirements mentioned above are met to support the claim and avoid potential denials or audits.

8. Historical information

CPT 58670 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the descriptor since its addition.

9. Similar codes to CPT 58670

Five similar codes to CPT 58670 and how they differentiate are:

  1. CPT 58661: This code involves laparoscopic removal of the fallopian tubes and/or ovaries, which is different from the fulguration of oviducts in CPT 58670.
  2. CPT 58662: This code describes laparoscopic lysis of adhesions, which is not related to the fulguration of oviducts in CPT 58670.
  3. CPT 58671: This code is for laparoscopic occlusion of oviducts by device (e.g., band, clip, or Falope ring), which is a different method of sterilization compared to fulguration in CPT 58670.
  4. CPT 58672: This code involves laparoscopic fimbrioplasty, which is a reconstructive procedure on the fimbriae of the fallopian tubes, unlike the sterilization procedure in CPT 58670.
  5. CPT 58673: This code is for laparoscopic salpingostomy, which involves creating a new opening in the fallopian tube, contrasting with the sealing off of oviducts in CPT 58670.

10. Examples

Here are 10 detailed examples of CPT code 58670 procedures:

  1. A 35-year-old woman with a history of multiple cesarean sections undergoes CPT 58670 for permanent sterilization due to increased risks associated with future pregnancies.
  2. A 42-year-old woman with three children opts for CPT 58670 as a permanent birth control method after discussing the risks and benefits with her provider.
  3. A 38-year-old woman with a history of severe endometriosis undergoes CPT 58670 to prevent pregnancy and reduce the risk of complications related to her condition.
  4. A 32-year-old woman with a genetic disorder that has a high risk of being passed on to her offspring chooses CPT 58670 for permanent sterilization.
  5. A 45-year-old woman with a history of hypertension and diabetes undergoes CPT 58670 due to the increased risks associated with pregnancy in her medical condition.
  6. A 40-year-old woman with a history of recurrent ectopic pregnancies undergoes CPT 58670 to prevent future ectopic pregnancies and associated complications.
  7. A 36-year-old woman with a history of pelvic inflammatory disease undergoes CPT 58670 to prevent pregnancy and reduce the risk of further complications related to her condition.
  8. A 33-year-old woman with a history of preterm deliveries and multiple miscarriages chooses CPT 58670 for permanent sterilization after discussing the risks and benefits with her provider.
  9. A 41-year-old woman with a history of uterine fibroids undergoes CPT 58670 to prevent pregnancy and reduce the risk of complications related to her condition.
  10. A 39-year-old woman with a history of ovarian cysts undergoes CPT 58670 to prevent pregnancy and reduce the risk of complications related to her condition.

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