Wiki 58661 vs 58670?

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mmelough93

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Hi. I was wondering if someone can help me understand the difference between 58661 and 58670. I have trouble deciding between the two when done for sterilization purposes. What would you code the following to?

Procedure Details
The patient was seen in the Holding Room. The risks, benefits, complications, treatment options, and expected outcomes were discussed with the patient. The possibilities of reaction to medication, pulmonary aspiration, perforation of viscus, bleeding, recurrent infection, the need for additional procedures, failure to diagnose a condition, and creating a complication requiring transfusion or operation were discussed with the patient. The patient concurred with the proposed plan, giving informed consent. The patient was taken to the Operating Room, identified as Haley Kerby and the procedure verified as Laparoscopy bilateral salpingectomy. A Time Out was held and the above information confirmed.

After induction of general anesthesia, the patient was placed in modified dorsal lithotomy position where she was prepped, draped, and catheterized in the normal, sterile fashion.

The cervix was visualized and an intrauterine manipulator was placed. A 0.5 cm umbilical incision was then performed. Veress needle was passed and pneumoperitoneum was established. A non-bladed 5mm trochar was inserted through umbilical site. Two additional 5mm trochars were inserted at RLQ and LLQ. The pelvis was inspected, normal uterus, ovaries and fallopian tubes noticed. Ligasure was used to coagulate, cut at mesosalpinx along the entire length of the fallopian tubes. The specimens were passed to pathology. Good hemostasis noticed.

Following the procedure the three sheath was removed after intra-abdominal carbon dioxide was expressed. The incision was closed with subcutaneous and subcuticular sutures of 4-0 Vicryl. The intrauterine manipulator was then removed.

Instrument, sponge, and needle counts were correct prior to abdominal closure and at the conclusion of the case.
Click to expand...
 
When solely for elective sterilization, the correct code per ACOG is 58670.
58661 is reserved for patients with a disease process.
Here's the ACOG article about it.
 

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  • ACOG coding salpingectomy for sterilization.pdf
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csperoni said:
When solely for elective sterilization, the correct code per ACOG is 58670.
58661 is reserved for patients with a disease process.
Here's the ACOG article about it.
Click to expand...
thank you for your response! I think the term "coagulate" but also that he removed the entire tubes is confusing me and had me going back and forth between 58611/58670. The article is great, I appreciate you sharing!
 
mmelough93 said:
thank you for your response! I think the term "coagulate" but also that he removed the entire tubes is confusing me and had me going back and forth between 58611/58670. The article is great, I appreciate you sharing!
Click to expand...
Please see the attached ACOG coding alert updated in July 2021. They have revised their recommendation for elective Laparoscopic Sterilizations to now use 58661 not 58670:
  1. ACOG Payment Advocacy and Policy Portal
  2. Solution home
  3. Coding Corner
  4. Gynecology Procedures

Coding Alert! Laparoscopy: Salpingectomy (Changes to CPT 58661 Recommendations)​

Lisa Satterfield
Modified on: Tue, 27 Jul, 2021 at 12:53 PM
Following a policy analysis of payer coverage and a discussion with the American Medical Association’s CPT Assistant Editorial Board and the CPT Panel’s Executive Committee, ACOG is revising recommendations for the use of CPT 58661: Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).

ACOG has determined that the evidence validates CPT 58661 for the removal of the fallopian tubes for sterilization laparoscopically, and not the previous recommendation, CPT 58670.

Therefore, ACOG is recommending that CPT 58661 is the appropriate code for the removal of the fallopian tubes for sterilization.

As always, please confirm with individual payers for prior authorization and billing.

 
wow, this is interesting! I am new to OBGYN and learning a lot from this specialty forum; participating and collecting info on varies topics. This was challenging to me and now we have updates! Thank you very much Tina for posting it for Us! I will add this to my notes. Keep sharing the vital information with us. We greatly appreciate your help. :)
 
tinagwhc said:
Please see the attached ACOG coding alert updated in July 2021. They have revised their recommendation for elective Laparoscopic Sterilizations to now use 58661 not 58670:
  1. ACOG Payment Advocacy and Policy Portal
  2. Solution home
  3. Coding Corner
  4. Gynecology Procedures

Coding Alert! Laparoscopy: Salpingectomy (Changes to CPT 58661 Recommendations)​

Lisa Satterfield
Modified on: Tue, 27 Jul, 2021 at 12:53 PM
Following a policy analysis of payer coverage and a discussion with the American Medical Association’s CPT Assistant Editorial Board and the CPT Panel’s Executive Committee, ACOG is revising recommendations for the use of CPT 58661: Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).

ACOG has determined that the evidence validates CPT 58661 for the removal of the fallopian tubes for sterilization laparoscopically, and not the previous recommendation, CPT 58670.

Therefore, ACOG is recommending that CPT 58661 is the appropriate code for the removal of the fallopian tubes for sterilization.

As always, please confirm with individual payers for prior authorization and billing.

Click to expand...
THANK YOU for the correction! I missed this update and love learning new things.
 
tinagwhc said:
Please see the attached ACOG coding alert updated in July 2021. They have revised their recommendation for elective Laparoscopic Sterilizations to now use 58661 not 58670:
  1. ACOG Payment Advocacy and Policy Portal
  2. Solution home
  3. Coding Corner
  4. Gynecology Procedures

Coding Alert! Laparoscopy: Salpingectomy (Changes to CPT 58661 Recommendations)​

Lisa Satterfield
Modified on: Tue, 27 Jul, 2021 at 12:53 PM
Following a policy analysis of payer coverage and a discussion with the American Medical Association’s CPT Assistant Editorial Board and the CPT Panel’s Executive Committee, ACOG is revising recommendations for the use of CPT 58661: Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).

ACOG has determined that the evidence validates CPT 58661 for the removal of the fallopian tubes for sterilization laparoscopically, and not the previous recommendation, CPT 58670.

Therefore, ACOG is recommending that CPT 58661 is the appropriate code for the removal of the fallopian tubes for sterilization.

As always, please confirm with individual payers for prior authorization and billing.

Click to expand...
Thank you for sharing!!!!!
 
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