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Wiki Preventive coverage for sterilization procedure 58661

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CBLENNIE

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I work for a payer in Idaho and we're seeing more and more providers performing CPT 58661 lap removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) for sterilization purposes. Our members are not aware that this procedure isn't considered a tubal ligation/ and is not required to be covered as a preventive services according to the ACA requirements for Prescribed Contraceptive Services, which would be covered without cost sharing if performed by an in-network provider and the plan is ACA compliant.

My question is are other commercial payers/carriers, particularly in Idaho, covering 58661 without cost-sharing as a preventive service if performed by an in-network provider and the plan is ACA compliant?

Thanks,
Corinne A. Littleton, CPC
The truth doesn't mean anything, it just is.
 
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