This is directly from TCI OB/GYN Newsletter. No modifier
Hope it helps.
Tip 4: Ligation Following C-Section? Check Out 58611
You'll report 58611 for a ligation following a cesarean. Cesarean delivery frequently offers the ob-gyn the chance to
perform tubal ligation immediately after the delivery, sparing the patient an additional surgical session.
Red flag: Billing for tubal ligation at the time of cesarean is almost always a problem with payers because they count
the cesarean incision as the incision for the ligation, Witt says. To these insurers, the ligation at the same session does
not represent significant effort for the ob-gyn.
Although ACOG specifically leaves tubal ligation off the list of bundled procedures in its policy on cesarean deliveries and
global ob care with cesarean, some carriers will pay little or nothing extra for the procedure, Witt says.
Money saver: Tubal ligation performed at the time of cesarean delivery can prove a significant source of revenue, so
practices should negotiate contract renewal to see that the procedure is reimbursed separately from the global package
or cesarean delivery codes. "Also, you should point out to the payer that +58611 is an add-on procedure that does not
take a modifier,” Witt says. The Resource-Based Relative Value Scale (RBRVS) valued this code based solely on the
intraoperative work.