How To Use CPT Code 58750

CPT 58750 describes the procedure known as tubotubal anastomosis, which involves suturing back together a portion of the fallopian tube that was previously transected during a sterilization procedure. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 58750?

CPT 58750 is used to describe the procedure of tubotubal anastomosis. This procedure is performed by a provider to reestablish a patient’s ability to become pregnant. It involves suturing together the portion of the fallopian tube that was previously cut during a sterilization procedure. The procedure is typically done through an abdominal incision.

2. Official Description

The official description of CPT code 58750 is: ‘Tubotubal anastomosis; abdominal approach.’

3. Procedure

1. The patient is placed in the supine position and given a general anesthetic.
2. The provider makes an incision in the lower abdomen, just above the pubic bone.
3. The peritoneum is incised, and the provider explores the abdomen, inspecting the abdominal cavity, uterus, fallopian tubes, and ovaries.
4. If necessary, the provider lyses any adhesions present and frees the tubal segments, being careful not to disturb the existing blood supply.
5. Using an operating microscope, the provider excises a portion of each end of the blocked fallopian tube to create an opening.
6. The provider sutures the two sections of the fallopian tube together.
7. A chromotubation may be performed to ensure that the fallopian tube is open.
8. The packing is removed, and the abdominal incision is closed with sutures.

4. Qualifying circumstances

CPT 58750 is performed on patients who have previously undergone a sterilization procedure and now wish to restore their fertility. The procedure is done via an abdominal approach and involves suturing the fallopian tube segments back together. It is important to note that coverage for this reconstructive surgery may vary among different payers.

5. When to use CPT code 58750

CPT code 58750 should be used when a provider performs a tubotubal anastomosis procedure through an abdominal approach. It is important to ensure that the patient has previously undergone a sterilization procedure and desires to restore their fertility. This code should not be used for other types of tubal anastomosis procedures or approaches.

6. Documentation requirements

To support a claim for CPT 58750, the provider must document the following information:

• Patient’s history of sterilization procedure
• Details of the procedure, including the abdominal approach
• Date of the procedure
• Specific steps taken during the procedure, such as lysis of adhesions and suturing of the fallopian tube segments
• Any additional procedures performed, such as chromotubation
• Complications, if any
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 58750, it is important to indicate whether the procedure was performed unilaterally or bilaterally. If both fallopian tubes are reconnected, a modifier 50 (Bilateral procedure) should be added to the code. It is also important to note that coverage for this procedure may vary among different payers, so it is advisable to check with the specific payer for their reimbursement policies.

8. Historical information

CPT 58750 was added to the Current Procedural Terminology system on January 1, 1990. The only notable update to the code was in 2017 when it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient who previously underwent a sterilization procedure desires to restore their fertility. The provider performs a tubotubal anastomosis through an abdominal approach, suturing the fallopian tube segments back together.
2. A woman who had her fallopian tubes blocked during a previous surgery wants to increase her chances of becoming pregnant. The provider performs a tubotubal anastomosis using an abdominal approach, successfully reconnecting the fallopian tube segments.
3. After a thorough evaluation, the provider determines that a patient who had a tubal ligation in the past is a good candidate for a tubotubal anastomosis. The procedure is performed through an abdominal incision, allowing the provider to suture the fallopian tube segments back together.
4. A couple who regrets their decision to undergo sterilization seeks the expertise of a provider to reverse the procedure. The provider performs a tubotubal anastomosis using an abdominal approach, successfully restoring the patient’s fertility.
5. A patient who had a previous sterilization procedure wants to explore the possibility of becoming pregnant again. The provider performs a tubotubal anastomosis through an abdominal incision, suturing the fallopian tube segments together to restore fertility.
6. After a thorough discussion with the patient, the provider performs a tubotubal anastomosis through an abdominal approach. The procedure involves suturing the fallopian tube segments back together, allowing the patient to have the possibility of becoming pregnant again.
7. A woman who had her fallopian tubes blocked during a sterilization procedure wants to explore the option of restoring her fertility. The provider performs a tubotubal anastomosis using an abdominal approach, successfully reconnecting the fallopian tube segments.