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The procedure described by CPT® Code 58670 involves a laparoscopic surgical technique aimed at performing a tubal ligation through the method of fulguration, which is the application of heat to destroy tissue. This procedure specifically targets the oviducts, also known as fallopian tubes, to prevent future pregnancies. During the operation, a tenaculum is utilized to grasp the cervix, allowing for the anteflexion of the uterus, which facilitates access to the abdominal cavity. A periumbilical port is established, and pneumoperitoneum is created by insufflating air into the abdominal cavity, enabling the surgeon to visualize the internal structures clearly through the laparoscope. The laparoscope is then inserted to inspect the abdominal cavity, where a cautery device is introduced to destroy a section of the fallopian tube, effectively occluding it. In some cases, the fallopian tube may also be transected, which means it is cut to further ensure that the passage for sperm and eggs is blocked. This procedure is minimally invasive, allowing for quicker recovery times and less postoperative discomfort compared to traditional open surgery.
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The procedure described by CPT® Code 58670 is indicated for the following conditions:
The procedure begins with the insertion of a tenaculum into the vagina, which is used to grasp the cervix. This maneuver allows the uterus to be anteflexed, positioning it for optimal access. Following this, a periumbilical port is placed, and pneumoperitoneum is established through the insufflation of air into the abdominal cavity. This step is crucial as it creates space for the laparoscope to be inserted. Once the laparoscope is in place, the surgeon inspects the abdominal cavity for any abnormalities. The next step involves the introduction of a cautery device, which is used to destroy a section of the fallopian tube through the process of fulguration. This destruction of tissue effectively occludes the fallopian tube, preventing the passage of eggs. In some cases, the surgeon may also choose to transect the fallopian tube, further ensuring that the pathway for sperm and eggs is blocked. After completing the procedure on one side, the same steps are repeated on the opposite side if necessary. Once the surgical steps are completed, the pelvic area is inspected for any signs of bleeding. The instruments are then withdrawn, and gentle pressure is applied to the abdomen to express any remaining air from the peritoneum. Finally, the portal incisions are closed to complete the procedure.
After the completion of the laparoscopic procedure, patients are typically monitored for any immediate complications. Post-procedure care may include pain management and instructions for activity restrictions to promote healing. Patients are advised to watch for any signs of infection or unusual symptoms, such as excessive bleeding or severe abdominal pain. Follow-up appointments may be scheduled to ensure proper recovery and to address any concerns that may arise. The expected recovery time is generally shorter compared to traditional open surgery, allowing patients to return to their normal activities more quickly.
| Short Descr | LAPAROSCOPY TUBAL CAUTERY | Medium Descr | LAPAROSCOPY FULGURATION OVIDUCTS | Long Descr | Laparoscopy, surgical; with fulguration of oviducts (with or without transection) | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 3 - Special payment adjustment rules for multiple endoscopic procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Endoscopic Base Code | 49320 Laparoscopy, abdomen, peritoneum, and omentum, diagnostic, with or without collection of specimen(s) by brushing or washing (separate procedure) | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 121 - Ligation of fallopian tubes |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AQ | Physician providing a service in an unlisted health professional shortage area (hpsa) | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | CR | Catastrophe/disaster related | FP | Service provided as part of family planning program | GC | This service has been performed in part by a resident under the direction of a teaching physician | GY | Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit | GZ | Item or service expected to be denied as not reasonable and necessary | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) | SG | Ambulatory surgical center (asc) facility service |
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| 2011-01-01 | Changed | Short description changed. |
| 2000-01-01 | Added | First appearance in code book in 2000. |
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