Use CPT 58662 for a laparoscopy procedure to destroy or excise cysts, tumors, or lesions in the pelvic viscera.
1. What Is CPT Code 58662?
CPT 58662 covers a laparoscopy procedure in which a provider aims to excise or destroy cysts, tumors, or lesions in the following areas of a female patient;
- the peritoneum;
- the rectum;
- the uterus; or the
The CPT book defines procedural code CPT 58662 as: “Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method.”
The 58662 CPT code procedure starts with placing the female patient in the dorsal lithotomy position. Then, they drape and prep the patient’s abdomen before administering the general anesthetic.
The surgeon continues by placing a uterine manipulator through the patient’s cervix. The uterine manipulator creates space in the uterus and makes it easier to operate on the patient.
Then, the abdominal cavity is entered near the patient’s belly button. Next, the provider either uses a Veress needle or an open incision for the placement of a laparoscope.
The abdomen is insufflated with CO2, which creates a pneumoperitoneum. They then put the female patient in the Trendelenburg position before making small incisions around the abdominal area.
The incisions are used for trocars to improve the view of the area and for inserting tools.
The surgeon might use robotic surgery. In that case, they dock the robot to the laparoscope.
The surgeon removes endometriosis or other lesions (for example, cysts on the ovaries, uterus, fallopian tubes, etc.) with the following technique.
The lesions are cauterized, vaporized, or excised, and the specimens are removed from the patient’s abdomen through the trocar site that is the closest by.
Next, the provider might perform chromotubation if they consider it medically necessary. This might be necessary to check if the fallopian tubes are open enough.
Finally, the surgeon deflates and irrigates the abdominal cavity and removes the trocars and the surgical instruments.
4. Billing Guidelines
You can use CPT code 58662 if the provider excises an ovarian cyst but does not remove any ovaries.
Do not use CPT 58662 if the pathology report indicates the presence of ovarian tissue in the specimen. In that case, you can report CPT code 58661 because it becomes a partial oophorectomy.
This code can be used if a surgeon removes endometrial implants or an ovarian cyst during surgery. Make sure to add modifier 22 if the surgeon documents significant additional work.