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CPT Code 58661 | Laparoscopic Adnexal Structure Removal

The 58661 CPT code covers a procedure in which an ovary or ovaries and one or both fallopian tubes are removed with a laparoscope.

1. What Is CPT 58661?

CPT 58661 can be used when a provider removes the ovary/ovaries of a patient. They also remove one or two fallopian tubes with a laparoscope.

2. Description

The CPT book describes the 58661 CPT code as follows: “Laparoscopy, surgical; with the removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).”

3. Procedure

The provider performs the surgery by placing the patient in the dorsal lithotomy position and administering a general anesthetic.

A uterine manipulator is inserted through the cervix to move the uterus during the surgery.

To insert a laparoscope, an incision is made near the belly button, either with a Veress needle or an open incision.

The abdomen is then insufflated with CO2 gas to create a pneumoperitoneum, and the patient is put in the Trendelenburg position. Small incisions are made around the abdomen to insert trocars for better viewing and to insert surgical tools.

If the surgery is performed using a robotic method, the robot is docked to the laparoscope at this time.

The infundibulopelvic ligament is isolated, and the ureter is protected while bleeding from the ovarian vessels is controlled.

The ovary and fallopian tube are then separated from any adhesions and removed from the abdomen through a trocar site or by making a small incision in the vaginal wall.

If an ovary contains a cyst, it is placed in a sterile bag to aspirate and deflate it without spilling its contents into the abdominal cavity.

This procedure is repeated on the other side of a bilateral procedure is performed. The abdomen is then irrigated and deflated, and all instruments and trocars are removed.

The trocar site fascia and skin are closed, and all instruments are removed from the vagina.

4. Does CPT Code 58661 Need A Modifier?

CPT code 58661 is listed in the Medicare database as a unilateral procedure. You can append modifier 50 to the claim in case of a bilateral salpingo-oophorectomy procedure.

5. Resources



CPT Professional 2022

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