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2025 CPT code 58661

Laparoscopy, surgical; with removal of adnexal structures (partial or total oophorectomy and/or salpingectomy).

As of May 2024, CPT guidelines state that code 58661 is for unilateral procedures. For bilateral procedures, append modifier 50. Previous guidelines considered 58661 as a bilateral code. Always refer to the most recent CPT guidelines when coding.

Modifier 50 (Bilateral Procedure) is used when the procedure is performed on both sides. Other modifiers may be applicable depending on specific circumstances.

Medical necessity for this procedure is established by the presence of a condition affecting the ovaries or fallopian tubes requiring surgical intervention, such as ovarian cysts, ectopic pregnancy, or prophylactic removal due to high risk of ovarian or fallopian tube cancer.

The physician is responsible for the complete surgical procedure, including patient positioning, anesthesia, laparoscopic access, manipulation of instruments, removal of the adnexal structures, and closure of the incisions.

In simple words: This is a minimally invasive surgery to remove one or both ovaries and/or fallopian tubes using a small camera and tiny instruments inserted through small incisions in the abdomen.

This code describes a laparoscopic procedure where the surgeon removes one or both ovaries and/or fallopian tubes. The procedure may involve partial or total removal of these structures. The surgery is performed using a laparoscope, a thin, lighted tube inserted through small incisions in the abdomen.A uterine manipulator is used, and the abdomen is inflated with CO2 gas to create space for the procedure. Specialized instruments are inserted through small incisions to dissect and remove the adnexal structures.

Example 1: A 35-year-old woman with a large ovarian cyst undergoes a laparoscopic removal of the affected ovary and fallopian tube (unilateral salpingo-oophorectomy)., A 50-year-old woman with a family history of ovarian cancer undergoes a laparoscopic removal of both ovaries and fallopian tubes (bilateral salpingo-oophorectomy) as a preventative measure., A 28-year-old woman with an ectopic pregnancy in her right fallopian tube undergoes a laparoscopic removal of the affected fallopian tube (unilateral salpingectomy).

Documentation should include operative report detailing the procedure, including the size and location of any masses or cysts, laterality (right, left, or bilateral), indication for surgery, and any complications. Pre-operative diagnostic findings (e.g. ultrasound, CT scan) supporting the medical necessity of the procedure should also be documented.

** Be sure to check with individual payers for specific billing requirements and coverage policies as they may vary.Robotic assistance may be used during this procedure, but it is not separately coded.

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