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Laparoscopic salpingectomy

M

MCCOSH

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1
Location
North Fort Myers, FL
I have a question regarding what code to use for laparoscopic salpingectomy without removal of the ovaries? Also what is the code when the fulgurates the tubes. What is the CPT code for that? Thank you.
 
When posting questions, it helps to show that you already researched the question, but are not sure of your answer, and include what code(s) you are considering. This way it can be more of a conversation to help everyone learn. See suggestions below.
58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral
58661 Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) 58670 Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
 
csperoni said:
When posting questions, it helps to show that you already researched the question, but are not sure of your answer, and include what code(s) you are considering. This way it can be more of a conversation to help everyone learn. See suggestions below.
58600 Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral
58661 Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy) 58670 Laparoscopy, surgical; with fulguration of oviducts (with or without transection)
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In regard to 58661 would this also apply if the physician does a right partial salpingectomy via robotic due to salpingitis not for sterilization? A previous coder billed this surgery as a 58661 and insurance denied it, i did my research and i am gearing towards changing 58661 to 58670. Wanted to find any input, it would be appreciated. Thank you

Procedure: R partial salpingectomy, robotic
EBL: minimal

Intraoperative consultation was requested to evaluate uterus and adnexa after extensive lysis of adhesions along right adnexa, colon, and posterior uterine serosa. Right fallopian tube appeared to be hemostatic but missing mid portion of the tube. Dilation and distortion of the fimbria was noted on the distal end. Decision was made to remove that portion of the fallopian tube. The fimbria was grasped, elevated, coagulated and cut along the mesosalpinx. The specimen was removed and hemostasis was confirmed. The pedicle was grasped and elevated allowing visualization of the infundibulo-pelvic ligament, the ovary, and the utero-ovarian ligament. All which appeared to be intact. The posterior uterine serosa was coagulated to obtain hemostasis with the bipolar cautery.
 
Hi, 58661 is complete or partial so would be the correct code. What was the reason for the denial? 58670 is fulguration of the tube, which was not performed.
 
rockylopez said:
THE DENIAL WAS FOR ICD 10 CODE THAT WAS USED WHICH WAS N70.91 - SALPINGITIS.
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Based on the information provided, 58661 seems to be the correct CPT. The diagnosis of salpingitis seems like a perfectly acceptable reason to remove the fallopian tube. Is the denial that the ICD10 does not justify the procedure? Or that the ICD10 is "unspecified"? Or some other diagnosis related denial?
 
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