Wiki 58700 with C-Section for sterilization

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Jdrietz

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Good afternoon... Providers want to utilize 58700 for sterilization with C section. This is a separate code and have always used 58611 in the past. Has anyone else used this code? I am looking for some documentation as well to support the use of 58611 for sterilization with C section vs 58700. I am leaning towards 58611 as the excision is already done for the C section. Thanks for your help :)
 
If the provider is tying, cutting or removing tubes for sterilization at the time of the C section, 58611 is exactly what is done. It is specifically an add on code with CS or other abdominal surgery.

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)

ACOG had issued guidance that the 58700 salpingectomy code was for disease process, not for sterilization procedures.
 

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Wow, this is a Great topic to discuss again! A few months ago, I was studying, researching Sterilization during c-section via Resection of Fallopian tubes. I found good material here in this forum and also article from ACOG that Christine mentioned above. Since our MDs do Salpingectomy during c-s by completely removing tubes, I brought this conflicting information to our team. The decision was to code 58700 because that was the procedure performed- removal of tubes ( the name of the procedure in Op notes is Salpingectomy, the performed procedure matched the description of 58700 and even pathology report showed speciment-Tubes). All indicators pointed to 58700. Do you think this rational is correct?
Thank you, Christine, and everyone for sharing your experience with us!
 
Whether or not I agree with it, the ACOG guidance is clearly to code 58611 for sterilization by salpingectomy at the time of C-section and never 58700.
This advise came about a few years ago when recommended practice became to remove the tubes rather than tie or cut as a way to help prevent cancer in the future as it was determined a majority of ovarian cancers actually start in the fallopian tubes.
I believe the rationale for the coding is that when you are removing the tube for sterilization only, and not for a disease process, you are doing less work than if you are removing a diseased tube. Specifically for removing the tubes during a C-section, I think I recall reading somewhere that it is less than 15 minutes additional vs tying tubes.
If you are not removing the tubes for sterilization, then 58700 would be appropriate.
 
Thank you Christine for sharing this documentation from ACOG and Jdrietz for the question :) I have a question in reference to c-section and salpingectomy if my OB Hospitalists was the assistant surgeon (80) to the c-section (59514) can he too bill for the 58611? Thank you!
 
Cyn00587 said:
Thank you Christine for sharing this documentation from ACOG and Jdrietz for the question :) I have a question in reference to c-section and salpingectomy if my OB Hospitalists was the assistant surgeon (80) to the c-section (59514) can he too bill for the 58611? Thank you!
Click to expand...
-80 is a valid modifier for 58611.
If your provider assisted on the salpingectomy as well as the c-section, you should bill both 59514-80 and 58611-80.
 
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