How To Use CPT Code 59151

CPT 59151 describes the laparoscopic treatment of ectopic pregnancy, specifically involving the removal of the fallopian tube and/or ovary. 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 59151?

CPT 59151 is used to describe a laparoscopic procedure for the treatment of ectopic pregnancy. In this procedure, the provider removes the fallopian tube and/or ovary in addition to addressing the ectopic pregnancy. This code is used when the ectopic pregnancy is located in the fallopian tube or around the ovary, or when the pregnancy has already caused damage to the fallopian tube. The procedure is performed using a laparoscope, a fiberoptic instrument that allows the provider to view and operate inside the abdominal cavity through small incisions.

2. Official Description

The official description of CPT code 59151 is: ‘Laparoscopic treatment of ectopic pregnancy; with salpingectomy and/or oophorectomy.’

3. Procedure

1. The patient is prepared and anesthetized, and placed in the dorsal lithotomy position.
2. The provider performs a pelvic examination and inserts a uterine manipulator through the cervix to manipulate the uterus during the surgery.
3. The provider enters the abdominal cavity near the belly button using a Veress needle or an open incision to place a laparoscope.
4. The provider insufflates the abdomen with carbon dioxide gas to create a pneumoperitoneum and puts the patient in the Trendelenburg position.
5. Small incisions are made around the abdominal area to insert trocars, which allow for better visualization and the addition of surgical tools.
6. If performing robotic surgery, the provider docks the robot to the laparoscope.
7. The provider inspects the abdominal cavity and locates the ectopic pregnancy.
8. The provider infiltrates the lining of the fallopian tube or top part of the uterus with vasopressin to reduce blood loss.
9. The provider aspirates any products of conception, blood clots, or free blood present.
10. If the fallopian tube is damaged, the provider removes it by incising a small wedge of uterine wall where the fallopian tube meets the body of the uterus.
11. If the ovary is damaged, the provider incises the infundibulopelvic ligament to release the ovary.
12. The provider washes out the pelvic cavity with saline and checks for bleeding.
13. The provider deflates the abdominal cavity, removes all instruments and trocars, and closes the trocar site, fascia, and skin.
14. All instruments are removed from the vagina.

4. Qualifying circumstances

CPT 59151 is used when the provider determines that the fallopian tube and/or ovary must be removed due to the ectopic pregnancy. This may be because the pregnancy is located in the fallopian tube or around the ovary, or because the pregnancy has already caused damage to the fallopian tube. The procedure is performed using a laparoscope, and the patient must be appropriately prepped and anesthetized.

5. When to use CPT code 59151

CPT code 59151 should be used when the provider performs a laparoscopic treatment for ectopic pregnancy and removes the fallopian tube and/or ovary. It is important to note that this code is specific to cases where the fallopian tube and/or ovary are removed. If the provider performs a different procedure for ectopic pregnancy, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 59151, the provider must document the following information:

• Confirmation of ectopic pregnancy
• Reason for removal of the fallopian tube and/or ovary
• Details of the laparoscopic procedure, including the use of a laparoscope and any additional surgical tools
• Specific steps taken during the procedure, such as infiltration of vasopressin, aspiration of products of conception, and incision and removal of the fallopian tube and/or ovary
• Confirmation of saline washout and absence of bleeding
• Closure of trocar site, fascia, and skin
• Removal of instruments from the vagina
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 59151, ensure that the procedure meets the criteria for this code, including the removal of the fallopian tube and/or ovary. It is important to follow the specific documentation requirements and include all necessary details in the claim. Additionally, be aware of any specific billing guidelines or modifiers that may be required by the payer.

8. Historical information

CPT 59151 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 patient undergoes a laparoscopic procedure for the treatment of ectopic pregnancy, during which the provider removes the fallopian tube due to the location of the pregnancy.
2. A laparoscopic procedure is performed to address an ectopic pregnancy that has caused damage to the fallopian tube and ovary, resulting in the removal of both structures.
3. The provider performs a laparoscopic treatment for ectopic pregnancy, removing the fallopian tube and performing a separate procedure to resect an ovarian ectopic pregnancy.