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.
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. ■