How To Use CPT Code 58943

CPT 58943 describes the surgical procedure known as oophorectomy, which involves the removal of part or all of one or both ovaries. 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 58943?

CPT 58943 is used to describe the surgical procedure called oophorectomy. This procedure involves the removal of part or all of one or both ovaries, depending on the extent of the malignancy. It may also include additional steps such as para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, and salpingectomy(s) or omentectomy. This code is specifically used for cases involving ovarian, tubal, or primary peritoneal malignancy.

2. Official Description

The official description of CPT code 58943 is: ‘Oophorectomy, partial or total, unilateral or bilateral; for ovarian, tubal or primary peritoneal malignancy, with para-aortic and pelvic lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, with or without salpingectomy(s), with or without omentectomy.’

3. Procedure

1. The patient is positioned in the lithotomy position and given a general anesthetic.
2. The provider makes an incision in the lower abdomen, just above the symphysis pubis.
3. The incision is extended through the underlying tissue and peritoneum.
4. The provider takes samples of the pelvic lymph nodes and sends them to a laboratory for testing.
5. The provider thoroughly examines the peritoneal cavity for any spread of cancer cells.
6. The peritoneum is washed with a saline solution, and samples of the peritoneum are obtained for examination.
7. The provider exposes the aortic lymph nodes and takes a biopsy of this lymph tissue located near the aorta.
8. The diaphragm is examined, and tissue samples are taken to check for the spread of the disease.
9. If necessary, the provider identifies the ovarian vessels and infundibulopelvic ligaments to remove the ovary and/or fallopian tube.
10. The provider may also perform an omentectomy, removing all or part of the omentum.
11. The abdominal incisions are closed with sutures.

4. Qualifying circumstances

CPT 58943 is used for patients with ovarian, tubal, or primary peritoneal malignancy. The procedure may involve the removal of part or all of one or both ovaries, along with additional steps such as lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, salpingectomy(s), or omentectomy. The specific circumstances and extent of the procedure will depend on the individual patient’s condition and the provider’s assessment.

5. When to use CPT code 58943

CPT code 58943 should be used when performing an oophorectomy for ovarian, tubal, or primary peritoneal malignancy. It is important to accurately document the specific indications for the procedure and ensure that it aligns with the official description of the code. This code should not be used for other indications or procedures unrelated to the specified malignancies.

6. Documentation requirements

To support a claim for CPT 58943, the provider must document the following information:

• Indication for the procedure, specifying ovarian, tubal, or primary peritoneal malignancy
• Details of any additional steps performed, such as lymph node biopsies, peritoneal washings, peritoneal biopsies, diaphragmatic assessments, salpingectomy(s), or omentectomy
• Date of the procedure
• Specific findings during the procedure, including any spread of cancer cells or abnormalities
• Details of the closure of the abdominal incisions
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 58943, it is important to ensure that the procedure aligns with the official description and documentation requirements. This code should not be reported with other codes unless they are directly related to the procedure and meet the necessary criteria. It is essential to follow the specific guidelines provided by the payer and accurately report the services provided.

8. Historical information

CPT 58943 was added to the Current Procedural Terminology system on January 1, 1990. Since then, there have been changes to the code description, including the addition of qualifying circumstances and additional steps. It is important to stay updated with any changes or revisions to ensure accurate reporting.

9. Examples

1. A patient undergoes a bilateral oophorectomy with para-aortic and pelvic lymph node biopsies, peritoneal washings, and peritoneal biopsies for ovarian malignancy.
2. A provider performs a unilateral oophorectomy with salpingectomy and diaphragmatic assessments for primary peritoneal malignancy.
3. An oophorectomy is performed on one ovary, along with an omentectomy, for tubal malignancy.
4. A patient undergoes a bilateral oophorectomy with para-aortic and pelvic lymph node biopsies, peritoneal washings, and diaphragmatic assessments for ovarian malignancy.
5. A provider performs a unilateral oophorectomy with salpingectomy and peritoneal biopsies for primary peritoneal malignancy.
6. An oophorectomy is performed on both ovaries, along with an omentectomy, for tubal malignancy.