Ob-Gyn Coding Alert

Question: Wondering if anyone is seeing docs doing salpingectomies at time of c-section’s? My docs are starting to do salpingectomies instead of ligation at time of the section. Normally for ligation, 58611 is the CPT® code we use. However, with the salpingectomy, would it still be the same, or 58700? Help is appreciated.

Massachusetts Subscriber

Answer: The American Congress of Obstetricians and Gynecologists (ACOG) has published information that leads many ob-gyns to think that it is better for the patient to do a salpingectomy rather than a tubal for sterilization. The reason is to prevent certain types of cancer that originate in the fallopian tube.

Many payers are not willing to pay more for a sterilization procedure, and especially not during cesarean. Code 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]) has historically paid very little (2.2 RVUs) as opposed to salpingectomy (58700, Salpingectomy, complete or partial, unilateral or bilateral [separate procedure]), which has 22.31 RVUs. It does not take a mathematician to understand why payers don’t want to pay this for this type of sterilization, but physicians would like them to. Bill if you want, but expect denials for CPT® and ICD code mismatch.