Yes, we do. We began to see providers using 58661 several years ago and after questioning it and a lot of back and forth, leadership decided to accept it. We work our denials and I do not recalling seeing any - can't say that they weren't denied at the beginning, but have not seen any recently for sure.
If you can negotiate with your payer to use 58661 for a preventive procedure be sure you have this in writing. ACOG has published that 58661 is NOT the correct code for a salpingectomy performed for sterilization purposes with one minor exception. In July 2016 they published the following information:
ACOG has recently published Committee Opinion 260, “Salpingectomy for Ovarian Cancer Prevention” January 2015. Per the Committee Opinion, new research indicates that “ovarian cancer may originate in the fallopian tube leading to a window of opportunity for gynecologists offering patients a salpingectomy during benign gynecologic surgeries as one of the few options available for ovarian cancer prophylaxis. Prophylactic salpingectomy may offer clinicians the opportunity to prevent ovarian cancer in their patients”. The Committee Opinion concludes, however, that randomized controlled trials are needed to support the validity of this approach to reduce the incidence of ovarian cancer.
The ACOG Coding Committee has also reviewed this issue and agrees that additional studies will need to be conducted to see if this procedure actually does decrease the risk of ovarian cancer development over time. The approach to performing hysterectomy or sterilization should not be influenced by the theoretical benefit of salpingectomy. Unfortunately, there is not a CPT procedure code for reporting prophylactic salpingectomies. However, surgeons should continue to observe and practice minimally invasive techniques.
Coding Options
When reporting a sterilization procedure during the time of a cesarean delivery, report 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)).
When performing a laparoscopic salpingectomy in addition to a primary procedure, or at a time of a laparoscopy for a gynecological procedure that does not include the adnexal structures, code
58661 (Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy)) is appropriate. (
note that this means other laparoscopic procedures must be performed at this same time so there is usually limited use for code 58661)
When performing an elective sterilization laparoscopically, code
58670 (Laparoscopy, surgical; with fulguration of oviducts (with or without transection)) is appropriate to report.
Code
58700 (Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)) should
never be used to report a sterilization procedure of any sort. This code was valued to include pathological changes of the fallopian tubes that cause complications such as blocked tubes or adhesions.
It is possible that a specific payer will
not cover prophylactic procedures or believe them to be medically necessary in spite of the recommendations in the medical literature. Alternatively, some payers may cover the service but the patient's specific plan may not. Documentation must reflect the actual reason for the service even if it is not reimbursed by payers and a specific diagnosis code needs to be linked to the procedure. Diagnosis codes that may be accepted will depend upon specific payer payment policies.