# Bilateral Salpingectomy for Sterlization



## thompsp1

Provider's operative report indicates "bilateral partial salpingectomy" which would be billed with 58661 and the diagnosis was sterilization.  Can this code be used or does 58670 cover this as the distal portion of the tubes were removed.  

Thanks


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## Munzueta

Good morning,

from the information you are provided, you are giving Laparoscopic codes so I will assume your case is a laparoscopic procedure. 

If the only purpose of the procedure was to do a salpingectomy (mearning a removal of the fallopian tube) then yes, the code will be 58661. This can be a procedure performed with a major surgery such as a hysterectomy (removal of the uterus and cervix) which can give you a different code.

Keep in mind the purpose of the salpingectomy is to remove the fallopian tube, which if i'm not mistaken from what you are asking, it would be what you're asking about the distal portion of the tubes.

I have attached an Illustration just for reference of what they do with the salpingectomy.

So your codes will be 58661 and ICD-10 code Z30.2 for the sterilization purpose.

hopefully this helps.

thank you,
Marco
AAPC El Paso Chapter President


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## thompsp1

Thank you this is very helpful


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## Munzueta

Happy to help!


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## shahzish

*58661 is the correct code as per AMA coding clinic*

CPT Code 58661

Coding Clinic for HCPCS, Third Quarter 2016: Page 4 

Coding advice contained in this issue is effective with procedures/services provided after October 31, 2016, unless otherwise noted.  

QUESTION 8

Can you please provide clarification regarding the use of CPT code 58661, Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) versus CPT code 58670, Laparoscopy, surgical; with fulguration of oviducts (with or without transection) if the fallopian tube was actually removed during the procedure? 

When a patient desires sterilization and the encounter is specifically for prophylactic treatment, which CPT would be appropriately reported? 

We were instructed that there is not a CPT code for the reporting of prophylactic salpingectomies and that the coder should code what was done. If the provider performed a laparoscopic salpingectomy for sterilization purposes, CPT code 58661 would be reported and not 58670. 

Other coding guidance resources have stated that CPT code 58661 would be reported for a disease process and CPT code 58670 would be reported for sterilization. Since the CPT codebook does not specify whether either code should be reported for the disease process or sterilization there is a lot of confusion if the operative report states "excision (removal) of the tube. 

ANSWER

Report CPT code 58661, Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy), would be reported for the bilateral salpingectomy. 

There is no CPT code for the reporting of prophylactic salpingectomies, so the coder should code what was done. Based on the operative report submitted fulguration of the fallopian tubes was not performed, therefore it would be inappropriate to report CPT code 58670. Code assignment should always be based on supportive documentation. When the documentation is unclear, query the physician. The diagnosis code will indicate the reason the procedure was performed. 

Regards,
Mohammed Shahbaaz-CPC.


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## mitchellde

while this can be extremely helpful to some you should know that information contained in Coding Clinics is copy protected and copy and paste from these publications is strictly prohibited.  You may reference the issue and the type of information contained but you cannot verbatim copy and paste.  This is stated on the inside front cover of the Coding CLinics.


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## ROBINHB

mohdshahbaaz said:


> *58661 is the correct code as per AMA coding clinic*
> 
> CPT Code 58661
> 
> Coding Clinic for HCPCS, Third Quarter 2016: Page 4
> 
> Coding advice contained in this issue is effective with procedures/services provided after October 31, 2016, unless otherwise noted.
> 
> QUESTION 8
> 
> Can you please provide clarification regarding the use of CPT code 58661, Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) versus CPT code 58670, Laparoscopy, surgical; with fulguration of oviducts (with or without transection) if the fallopian tube was actually removed during the procedure?
> 
> When a patient desires sterilization and the encounter is specifically for prophylactic treatment, which CPT would be appropriately reported?
> 
> We were instructed that there is not a CPT code for the reporting of prophylactic salpingectomies and that the coder should code what was done. If the provider performed a laparoscopic salpingectomy for sterilization purposes, CPT code 58661 would be reported and not 58670.
> 
> Other coding guidance resources have stated that CPT code 58661 would be reported for a disease process and CPT code 58670 would be reported for sterilization. Since the CPT codebook does not specify whether either code should be reported for the disease process or sterilization there is a lot of confusion if the operative report states "excision (removal) of the tube.
> 
> ANSWER
> 
> Report CPT code 58661, Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy), would be reported for the bilateral salpingectomy.
> 
> There is no CPT code for the reporting of prophylactic salpingectomies, so the coder should code what was done. Based on the operative report submitted fulguration of the fallopian tubes was not performed, therefore it would be inappropriate to report CPT code 58670. Code assignment should always be based on supportive documentation. When the documentation is unclear, query the physician. The diagnosis code will indicate the reason the procedure was performed.
> 
> Regards,
> Mohammed Shahbaaz-CPC.



Hello all,
   Because AMA/CPT do not provide enough detail in their guidance on "prophylactic salpingectomy", I use the ACOG guidance as my support for using 58670 (Lap, surgical; with fulguration of oviducts with our without transection) as my code of choice for " LAP elective sterilization".  The ACOG Coding Committee updated their guidance in the attached statement on 5/14/2019. I also recommend my providers add a modifier 22 to let the insurance company know that they performed more than what is stated in the code description. They document their additional work and additional time involved.
Best regards,
Robin H. Frankland, CPC, CPMA, COBGC, CPC-I, CEMA


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## nsteinhauser

Hi Robin,
This is confusing.  Does using 58661 HAVE to include removal of oviduct along with the tube?  CPT 58661 ="partial or total oophorectomy and/or salpingectomy".  If the "or" at the end means it can represent JUST removal of a tube, then I would chose that over the 58670 because CPT 58670 = "destruction of an oviduct (the uterine tube) with or without complete cutting through the fallopian tubes (transection)"
If that's the case, it becomes a matter of surgical technique:  surgical removal of part or all of the tube - or - using electro cautery to destroy or cut apart part or all of the tube.  Regardless of the reason (sterilization, for instance) I would think the surgical method used would determine the code.
Thank you in advance for any comments, thoughts.
Nancy


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## csperoni

UPDATE!!
Even though this thread is older, I know many people research before posting a question that has been asked and answered previously.  I was recently corrected that laparoscopic removal of fallopian tubes, even for sterilization is now recommended by ACOG as 58661 NOT 58670 as previously advised.  
https://acogcoding.freshdesk.com/su...gectomy-changes-to-cpt-58661-recommendations-  states:  
Coding Alert! Laparoscopy: Salpingectomy (Changes to CPT 58661 Recommendations)​ *                    Lisa Satterfield                  * 
Modified on: Tue, 27 Jul, 2021 at 12:53 PM

Following a policy analysis of payer coverage and a discussion with the American Medical Association’s CPT Assistant Editorial Board and the CPT Panel’s Executive Committee, ACOG is revising recommendations for the use of CPT 58661: _Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)_.
ACOG has determined that the evidence validates CPT 58661 for the removal of the fallopian tubes for sterilization laparoscopically, and not the previous recommendation, CPT 58670.
Therefore, ACOG is recommending that CPT 58661 is the appropriate code for the removal of the fallopian tubes for sterilization.
As always, please confirm with individual payers for prior authorization and billing.


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