Anesthesia Coding Alert

Question: Which anesthesia code should we use for CPT 58611 (postpartum tubal ligation), which does not have a corresponding anesthesia code, and how many units should we assign to it? The primary procedure is 59514 (cesarean delivery only).

Minnesota Subscriber

Answer: Code 58611 is not a primary procedure and does not have a corresponding anesthesia code. Because the tubal ligation is performed after the cesarean section, 00857 (neuraxial analgesia/anesthesia for labor ending in a cesarean delivery [includes any repeat subarachnoid needle placement and drug injection and/or any necessary replacement of an epidural catheter during labor]) is appropriate because it is for cases that begin with labor and end in an unscheduled cesarean section. If the ligation is performed after a scheduled cesarean section, code 00850 (anesthesia for intraperitoneal procedures in lower abdomen including laparoscopy; cesarean section) would be correct. The words scheduled and unscheduled determine which code to use.

You would also bill for the time associated with the tubal ligation. If it is performed during the C-section, bill the higher procedure 00850 at seven base units plus time. If it is performed separately and involves a different anesthetic (separate induction and emergence), bill 00840, which is six base units plus time and includes occlusion or ligation of the fallopian tubes.