How To Use CPT Code 58970

CPT 58970 describes the procedure of follicle puncture for oocyte retrieval, which is a crucial step in the process of in vitro fertilization (IVF). This article will provide a comprehensive overview of CPT code 58970, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 58970?

CPT 58970 is used to describe the procedure of follicle puncture for oocyte retrieval, which is an essential part of the in vitro fertilization (IVF) process. During this procedure, a healthcare provider creates multiple punctures in the ovary to retrieve eggs for fertilization in a laboratory. The provider typically uses a needle inserted through the vaginal wall to perform this procedure.

2. Official Description

The official description of CPT code 58970 is: ‘Follicle puncture for oocyte retrieval, any method.’ It is important to note that for radiological supervision and interpretation during this procedure, CPT code 76948 should be used.

3. Procedure

1. The healthcare provider positions the patient in the dorsal lithotomy position and administers intravenous anesthesia.
2. Using ultrasound guidance, the provider inserts a needle attached to a suction device through the vaginal wall and into an ovarian follicle.
3. The provider aspirates follicle fluid from multiple follicles on each ovary, removing and reinserting the needle multiple times.
4. After aspirating each mature follicle, the provider removes the needle and checks for any bleeding at the puncture sites.
5. The follicular fluid is then sent to an IVF technician, who verifies the number of oocytes obtained during the retrieval.

4. Qualifying circumstances

CPT 58970 is performed for patients undergoing in vitro fertilization (IVF) who require follicle puncture for oocyte retrieval. This procedure is typically performed by a healthcare provider with expertise in reproductive medicine. The patient must meet the necessary criteria for IVF, and the procedure must be performed using any appropriate method for follicle puncture.

5. When to use CPT code 58970

CPT code 58970 should be used when a healthcare provider performs follicle puncture for oocyte retrieval as part of the IVF process. It is important to note that this code should not be used for radiological supervision and interpretation, as that requires a separate code (CPT 76948).

6. Documentation requirements

To support a claim for CPT code 58970, the healthcare provider must document the following information:

• Indication for the procedure and the patient’s eligibility for IVF
• Details of the procedure, including the method used for follicle puncture
• Date and time of the procedure
• Number of follicles aspirated and any complications encountered
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 58970, it is important to ensure that the procedure is performed for oocyte retrieval during the IVF process. Additionally, if radiological supervision and interpretation are performed during the procedure, CPT code 76948 should be reported separately. It is crucial to follow the specific guidelines and requirements of the payer when submitting claims for this procedure.

8. Historical information

CPT code 58970 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A reproductive medicine specialist performing follicle puncture for oocyte retrieval using transvaginal ultrasound guidance.
2. A healthcare provider performing follicle puncture for oocyte retrieval during an IVF procedure using laparoscopic guidance.
3. A fertility specialist performing follicle puncture for oocyte retrieval using transabdominal ultrasound guidance.
4. A reproductive endocrinologist performing follicle puncture for oocyte retrieval using both laparoscopic and transabdominal ultrasound guidance.
5. A healthcare provider performing an unlisted procedure related to oocyte retrieval during an IVF process.