How To Use CPT Code 58720
CPT 58720 refers to a salpingo-oophorectomy procedure, which involves the removal of all or part of a fallopian tube and ovary, either unilaterally or bilaterally. This article will cover the description, procedure, qualifying circumstances, usage, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 58720.
1. What is CPT 58720?
CPT 58720 is a medical procedure code used to describe a salpingo-oophorectomy, which involves the removal of all or part of a fallopian tube and ovary. This procedure can be performed unilaterally (on one side) or bilaterally (on both sides). It is typically performed via an abdominal incision and is used to treat various conditions, such as ovarian cysts, endometriosis, or cancer.
2. 58720 CPT code description
The official description of CPT code 58720 is: “Salpingo-oophorectomy, complete or partial, unilateral or bilateral (separate procedure)”.
- The patient is placed in the supine position and administered general anesthesia.
- The provider makes an incision in the lower abdomen just above the pubic bone.
- The peritoneum is incised, and the abdomen is explored.
- An incision is made to expose the broad ligament.
- The fallopian tube is dissected away from the ligament and removed from the abdomen.
- The infundibulopelvic ligament is incised to free the ovary from its connection to the pelvic wall, and the ovary is removed from the abdomen.
- If performing a bilateral salpingo-oophorectomy, steps 5 and 6 are repeated for the other fallopian tube and ovary.
- Bleeding is controlled, and hemostasis is obtained.
- The abdomen is closed, and a Foley catheter is placed to promote gravity drainage.
4. Qualifying circumstances
Patients eligible to receive CPT 58720 services are those who have been diagnosed with conditions that require the removal of one or both fallopian tubes and ovaries. These conditions may include, but are not limited to, ovarian cysts, endometriosis, pelvic inflammatory disease, ectopic pregnancy, or cancer. The decision to perform a salpingo-oophorectomy is typically based on the patient’s medical history, symptoms, and the results of diagnostic tests such as imaging studies and blood tests.
5. When to use CPT code 58720
CPT code 58720 should be used when billing for a salpingo-oophorectomy procedure, either complete or partial, unilateral or bilateral. This code is appropriate for use when the procedure is performed as a separate, standalone surgery and not in conjunction with other procedures. It is essential to ensure that the patient’s medical records support the need for this procedure and that all necessary documentation is in place to justify the use of this code.
6. Documentation requirements
To support a claim for CPT 58720, the following information should be documented in the patient’s medical record:
- Patient’s medical history and symptoms
- Results of diagnostic tests, such as imaging studies and blood tests
- Diagnosis requiring the salpingo-oophorectomy procedure
- Details of the surgical procedure, including the approach, steps performed, and any complications encountered
- Postoperative care and follow-up instructions
7. Billing guidelines
When billing for CPT 58720, it is essential to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips for billing this code include:
- Verify the patient’s insurance coverage and obtain any necessary pre-authorizations or referrals.
- Ensure that the patient’s medical record contains all required documentation to support the use of CPT 58720.
- Use the appropriate modifiers, if necessary, to indicate any special circumstances related to the procedure.
- Review the payer’s specific guidelines and policies regarding the billing of CPT 58720 to avoid claim denials or delays in payment.
8. Historical information
CPT 58720 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Medicare Inpatient Only (IPO) list.
9. Similar codes to CPT 58720
There are several other CPT codes related to salpingo-oophorectomy procedures that differentiate from CPT 58720:
- CPT 58700: This code is used for a unilateral salpingo-oophorectomy, where only one fallopian tube and ovary are removed.
- CPT 58740: This code is used for a laparoscopic salpingo-oophorectomy, which is a minimally invasive approach to the procedure.
- CPT 58940: This code is used for an oophorectomy, which involves the removal of one or both ovaries without the removal of the fallopian tubes.
- CPT 58661: This code is used for a laparoscopic removal of the fallopian tubes and ovaries, either unilateral or bilateral, for a pathological condition.
- CPT 58925: This code is used for the removal of an ovarian cyst, which may be performed in conjunction with a salpingo-oophorectomy.
Here are ten detailed examples of CPT code 58720 procedures:
- A 45-year-old woman with a large ovarian cyst undergoes a unilateral salpingo-oophorectomy to remove the affected ovary and fallopian tube.
- A 32-year-old woman with severe endometriosis undergoes a bilateral salpingo-oophorectomy to alleviate her symptoms and improve her quality of life.
- A 60-year-old woman with ovarian cancer undergoes a bilateral salpingo-oophorectomy as part of her cancer treatment plan.
- A 28-year-old woman with a history of ectopic pregnancies undergoes a unilateral salpingo-oophorectomy to remove the damaged fallopian tube and ovary.
- A 50-year-old woman with a large, complex ovarian mass undergoes a bilateral salpingo-oophorectomy to remove both ovaries and fallopian tubes for further evaluation and treatment.
- A 38-year-old woman with chronic pelvic pain and a history of pelvic inflammatory disease undergoes a bilateral salpingo-oophorectomy to alleviate her symptoms.
- A 55-year-old woman with a high risk of ovarian cancer due to a strong family history undergoes a prophylactic bilateral salpingo-oophorectomy to reduce her risk of developing the disease.
- A 47-year-old woman with a large, symptomatic ovarian cyst undergoes a unilateral salpingo-oophorectomy to remove the affected ovary and fallopian tube.
- A 40-year-old woman with a history of recurrent ovarian cysts undergoes a bilateral salpingo-oophorectomy to prevent further cyst formation and complications.
- A 35-year-old woman with a history of endometriosis and infertility undergoes a unilateral salpingo-oophorectomy to remove an endometrioma and improve her chances of conceiving.