How To Use CPT Code 58662

CPT 58662 is a surgical laparoscopy code for the fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method. This article will cover the description, procedure, qualifying circumstances, when to use the code, documentation requirements, billing guidelines, historical information, similar codes, and examples of CPT 58662 procedures.

1. What is CPT 58662?

CPT 58662 is a Current Procedural Terminology code used to describe a specific type of laparoscopic surgery involving the destruction or removal of lesions, tumors, or cysts found on the ovary, pelvic viscera, or peritoneal surface. This code is used by medical professionals to accurately document and bill for this particular surgical procedure.

2. 58662 CPT code description

The official description of CPT code 58662 is: Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method.

3. Procedure

The 58662 procedure involves the following steps:

1. Positioning the patient in the dorsal lithotomy position.
2. Prepping and draping the abdomen.
3. Administering general anesthesia.
4. Placing a uterine manipulator through the cervix to move the uterus during surgery.
5. Entering the abdominal cavity near the belly button using a Veress needle or an open incision and placing a laparoscope.
6. Insufflating the abdomen with CO2 gas to create a pneumoperitoneum and positioning the patient in the Trendelenburg position.
7. Making small incisions around the abdominal area to insert trocars for better visualization and insertion of surgical tools.
8. Excising, vaporizing, or cauterizing lesions or endometrial implants in the anterior or posterior cul-de-sacs and other areas, avoiding damage to the ureters, colon, or blood vessels.
9. Removing any specimens from the abdomen through the closest trocar site.
10. Performing chromotubation, if necessary, to check the openness of the fallopian tubes.
11. Irrigating and deflating the abdominal cavity, and removing all instruments and trocars.
12. Closing the trocar site fascia and skin and removing all instruments from the vagina.

4. Qualifying circumstances

Patients eligible to receive CPT code 58662 services are those who have been diagnosed with lesions, tumors, or cysts on the ovary, pelvic viscera, or peritoneal surface that require surgical intervention. This may include patients with endometriosis, ovarian cysts, or other pelvic abnormalities. The decision to perform this procedure is typically based on the patient’s medical history, symptoms, and diagnostic imaging results.

5. When to use CPT code 58662

It is appropriate to bill the 58662 CPT code when a provider performs a laparoscopic surgery involving the fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method. This code should be used to accurately document and bill for this specific surgical procedure.

6. Documentation requirements

To support a claim for CPT 58662, the following information should be documented in the patient’s medical record:

• Patient’s medical history and symptoms.
• Diagnostic imaging results, such as ultrasound or MRI, indicating the presence of lesions, tumors, or cysts.
• Indication for the surgical procedure and the specific method used (fulguration or excision).
• Detailed description of the surgical procedure, including the steps performed and any complications encountered.
• Postoperative care instructions and follow-up plan.

7. Billing guidelines

When billing for CPT code 58662, it is important to follow the appropriate guidelines and rules to ensure accurate reimbursement. Some tips and codes that apply to CPT code 58662 include:

• Report code 58662 if the provider excises an ovarian cyst but does not remove either ovary in the process.
• If the pathology report indicates the presence of ovarian tissue in the specimen, the procedure becomes a partial oophorectomy, and 58661 should be reported instead.
• If the provider documents significant additional work during a more extensive surgery, the addition of modifier 22, Increased procedural service requiring work substantially greater than typically required, may be an option.

8. Historical information

CPT 58662 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Similar codes to CPT 58662

Five similar codes to CPT 58662 and how they differentiate from CPT 58662 are:

1. CPT 58660: This code is used for laparoscopic lysis of adhesions, which is a different procedure than the fulguration or excision of lesions.
2. CPT 58661: This code is used for laparoscopic removal of the ovary and/or fallopian tube, which is a more extensive procedure than CPT 58662.
3. CPT 58670: This code is used for laparoscopic occlusion of the fallopian tubes, which is a different procedure than the fulguration or excision of lesions.
4. CPT 58671: This code is used for laparoscopic removal of the fallopian tubes, which is a different procedure than the fulguration or excision of lesions.
5. CPT 58679: This code is used for unlisted laparoscopic procedures involving the female reproductive system, which may include procedures that do not fit into the specific categories of the other codes.

10. Examples

Here are 10 detailed examples of CPT code 58662 procedures:

1. Laparoscopic excision of endometriosis lesions on the pelvic peritoneum.
2. Laparoscopic fulguration of ovarian cysts.
3. Laparoscopic removal of a benign tumor from the uterus.
4. Laparoscopic excision of adhesions involving the ovaries and fallopian tubes.
5. Laparoscopic vaporization of endometrial implants in the anterior and posterior cul-de-sacs.
6. Laparoscopic removal of a dermoid cyst from the ovary.
7. Laparoscopic excision of a paratubal cyst.
8. Laparoscopic removal of a pelvic mass involving the bladder and uterus.
9. Laparoscopic excision of a uterine fibroid.
10. Laparoscopic fulguration of endometriosis lesions on the rectosigmoid colon.