How To Use CPT Code 58605

CPT 58605 describes the procedure of ligation or transection of the fallopian tubes, which can be performed through either an abdominal or vaginal approach. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 58605?

CPT 58605 is used to describe the surgical procedure of ligation or transection of the fallopian tubes. This procedure can be performed either through an abdominal or vaginal approach. It is typically done after a vaginal delivery and before the patient is discharged from the hospital. The purpose of this procedure is to prevent future pregnancies by cutting or tying off one or both fallopian tubes.

2. Official Description

The official description of CPT code 58605 is: ‘Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure).’ It is important to note that for laparoscopic procedures, a different set of CPT codes should be used (58670, 58671).

3. Procedure

1. The procedure can be performed through either an abdominal or vaginal approach.
2. For the vaginal approach, the patient is placed in the dorsal lithotomy position and given a general anesthetic.
3. The provider exposes the cervix and grasps the lip of the cervix with a tenaculum.
4. An incision is made in the vaginal wall, and a retractor is used to expose the posterior cul-de-sac.
5. The provider then grasps a fallopian tube with a clamp and brings it out into the operative field.
6. The fallopian tube is folded in the middle, and sutures are placed below the fold to create a loop.
7. The loop is incised, and a small section of the tube is removed.
8. The cut ends of the tube are sutured closed.
9. If a bilateral procedure is desired, the same steps are repeated for the other fallopian tube.
10. For the abdominal approach, the patient is placed in the supine position and given a general anesthetic.
11. An incision is made in the umbilical area to expose the fallopian tube.
12. A clamp is inserted to bring the fallopian tube into view.
13. The fallopian tube is ligated and incised in the same manner as the vaginal approach.
14. If a bilateral procedure is desired, the same steps are repeated for the other fallopian tube.
15. The incisions are closed with sutures.

4. Qualifying circumstances

CPT 58605 is performed on postpartum patients who have undergone a vaginal delivery. It is used to prevent future pregnancies by ligating or transecting one or both fallopian tubes. The procedure can be performed unilaterally or bilaterally, depending on the patient’s needs. It is important to note that this code should not be reported with modifier 52, which indicates reduced services.

5. When to use CPT code 58605

CPT code 58605 should be used when a provider performs the ligation or transection of the fallopian tubes through either an abdominal or vaginal approach. It is specifically used for postpartum patients who have undergone a vaginal delivery and are still hospitalized. This code should not be reported with modifier 52, as it represents a complete procedure.

6. Documentation requirements

To support a claim for CPT 58605, the provider must document the following information:

• Patient’s postpartum status and indication for the procedure
• Approach used (abdominal or vaginal)
• Date of the procedure
• Details of the procedure, including any complications or additional steps taken
• Unilateral or bilateral procedure
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 58605, ensure that the procedure is performed during the same hospitalization as a separate procedure. It is important to use the appropriate approach code (abdominal or vaginal) based on the method used for the ligation or transection. Modifier 79 should be appended if the procedure is performed on a different date than the vaginal delivery. Modifier 59 should be used if the procedure is performed on the same date as the vaginal delivery but is considered a distinct procedure. Avoid using modifier 52, as it indicates reduced services.

8. Historical information

CPT 58605 was added to the Current Procedural Terminology system on January 1, 1990. The only notable historical change is that it was added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A provider performs a vaginal ligation of the fallopian tubes on a postpartum patient who has undergone a vaginal delivery.
2. An abdominal ligation of the fallopian tubes is performed on a postpartum patient who has undergone a vaginal delivery.
3. A provider performs a bilateral transection of the fallopian tubes through a vaginal approach on a postpartum patient.
4. An abdominal ligation of the fallopian tubes is performed on a postpartum patient who has undergone a cesarean delivery.