Question Is it 58661 or 58670 ?

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The OP report says "the left tube mesosalpinx was serially cauterized and transected with the LigaSure device and the cornual was also cauterized and transected. the tube was removed from the abdomen. note continues with right side done the same way.
I have always coded this 58670 = cauterized for sterilization.
Our hospital says because the OP report says " the tube was removed from the abdomen" it should be code 58661 for remove adnexal structure
The 58670 is paid 100% The 58661 is subject to deductible and co-ins
HELP - what is the proper way to code this?
thanks for your help -- sign me frustrated in NewBern


True Blue
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Several years ago, ACOG came out with the clinical recommendation for removal of fallopian tubes during sterilization as many ovarian cancers actually begin as fallopian tube abnormalities.
Their original guidance was to use 58670 for laparoscopic tube removal for sterilization. Last year, they changed that guidance and now advise 58661 is the correct code. states:

"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."

By using the sterilization diagnosis, it is POSSIBLE the carrier would still cover 58661 at 100%, but that is their decision.

PS - A coder's responsibility is to use the most accurate codes, regardless of whether or not the insurance will cover it. Per ACOG, the correct code for this is 58661.