Ob-Gyn Coding Alert

Question: My ob-gyn wants to utilize 58700 for sterilization with c-section. This is a separate code, and I have always used +58611 in the past. Has anyone else used this code? I am looking for some documentation as well to support the use of +58611 for sterilization with c-section versus 58700. I am leaning towards +58611 as the excision is already done for the c-section. What should I do?

South Carolina Subscriber

Answer: If the ob-gyn is tying, cutting or removing tubes for sterilization at the time of the c-section, then +58611 (Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure)) perfectly encapsulates this work. This code is specifically an add-on code with c-section or other abdominal surgery.

Watch out: The American College of Obstetricians and Gynecologists (ACOG) issued guidance to never report 58700 (Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)). This advice came about a few years ago when it became a recommended practice to remove the tubes rather than tie or cut to help prevent cancer in the future, as it was determined a majority of ovarian cancers actually start in the fallopian tubes.

When you are removing the tube for sterilization only and not for a disease process, you are doing less work than if you are removing a diseased tube. Specifically, for removing the tubes during a c-section, this service takes less than 15 minutes additional versus tying tubes. If you are not removing the tubes for sterilization, then you should report 58700.