How To Use CPT Code 58673

CPT 58673 describes a laparoscopic surgical procedure involving the creation of a new opening at the end of the fallopian tube. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 58673?

CPT 58673 involves a laparoscopic surgical procedure in which a provider creates a new opening at the end of the fallopian tube. This allows eggs from the ovary to pass into the uterus, facilitating fertility. It is important to note that this code is used for unilateral procedures, meaning it is performed on one side only. If the provider performs the procedure on both fallopian tubes, the modifier 50 should be added to indicate a bilateral procedure.

2. Official Description

The official description of CPT code 58673 is: ‘Laparoscopy, surgical; with salpingostomy (salpingoneostomy).’ It is important to note that codes 58672 and 58673 are used to report unilateral procedures, and for bilateral procedures, the modifier 50 should be used.

3. Procedure

1. The provider places the patient in the dorsal lithotomy position and administers a general anesthetic.
2. A uterine manipulator is inserted through the cervix to facilitate movement of the uterus during the surgery.
3. The provider enters the abdominal cavity near the belly button using a Veress needle or an open incision and places a laparoscope.
4. The abdomen is insufflated with CO2 gas to create a pneumoperitoneum, and the patient is placed in the Trendelenburg position.
5. Small incisions are made around the abdominal area to insert trocars, which allow for better visualization and the insertion of surgical tools.
6. If performing robotic surgery, the provider docks the robot to the laparoscope.
7. The provider isolates the distal end of the fallopian tube and makes a crosscut incision near the closed end.
8. Multiple flaps are created by folding back the incised tissue with a laser or sutures.
9. Chromotubation may be performed to ensure the new opening in the fallopian tube is open.
10. The abdominal cavity is irrigated and deflated, and all instruments and trocars are removed.
11. The trocar site fascia and skin are closed, and all instruments are removed from the vagina.

4. Qualifying circumstances

CPT 58673 is performed on patients who require a surgical reopening of a uterine tube with thickened ends due to fimbrial adhesions. Adhesions are fibrous bands of internal scar tissue that connect tissues not normally connected, often as a result of injury during surgery. In this case, the adhesions develop in the uterus and are referred to as uterine synechiae. The procedure is typically performed on patients who are experiencing fertility issues due to the closure of the fallopian tube.

5. When to use CPT code 58673

CPT code 58673 should be used when a provider performs a laparoscopic surgical procedure involving the creation of a new opening at the end of the fallopian tube. It is important to note that this code is used for unilateral procedures, meaning it is performed on one side only. If the provider performs the procedure on both fallopian tubes, the modifier 50 should be added to indicate a bilateral procedure.

6. Documentation requirements

To support a claim for CPT 58673, the provider must document the following information:

• Patient’s diagnosis and the need for the surgical procedure
• Details of the laparoscopic procedure performed, including the specific steps taken
• Date of the procedure
• Start and end time of the procedure
• Any additional procedures performed during the same session
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 58673, ensure that the procedure is performed as a laparoscopic surgical procedure involving the creation of a new opening at the end of the fallopian tube. Use the appropriate modifier (modifier 50) if the procedure is performed bilaterally. It is important to follow the specific guidelines provided by the payer and ensure accurate documentation to support the claim.

8. Historical information

CPT 58673 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates to the code since its addition.

9. Examples

1. A provider performs a laparoscopic surgical procedure involving the creation of a new opening at the end of the fallopian tube on a patient experiencing fertility issues.
2. A patient undergoes a laparoscopic procedure in which a provider creates a new opening in the fallopian tube to improve fertility.
3. A provider performs a laparoscopic surgical procedure to reopen a closed fallopian tube in a patient with uterine synechiae.
4. A laparoscopic surgical procedure is performed on a patient to create a new opening at the end of the fallopian tube and improve fertility.
5. A provider performs a laparoscopic procedure involving the creation of a new opening in the fallopian tube to address fertility issues in a patient.
6. A patient undergoes a laparoscopic surgical procedure to reopen a closed fallopian tube and improve fertility.
7. A provider performs a laparoscopic procedure to create a new opening at the end of the fallopian tube in a patient experiencing fertility issues.