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2025 CPT code 58770

Salpingostomy (salpingoneostomy):Surgical reopening of a blocked fallopian tube to restore fertility.

Follow all current CPT coding guidelines.The use of modifier 50 for bilateral procedures is indicated. Appropriate documentation is crucial for accurate coding and reimbursement.

Modifiers 50 (bilateral procedure), 22 (increased procedural services), 51 (multiple procedures), and others as clinically indicated may be appended to 58770 as needed.

Medical necessity for salpingostomy is established when a woman desires to conceive, and tubal obstruction is confirmed by appropriate imaging studies to be the cause of infertility.The procedure is considered medically necessary to restore fertility. The clinical documentation should demonstrate the relationship between tubal obstruction, infertility, and the need for the surgery.

The surgeon's responsibilities include patient positioning, anesthesia administration, abdominal incision, peritoneal incision, abdominal exploration, inspection of the abdominal cavity, uterus, fallopian tubes, and ovaries, isolation of the distal fallopian tube, incision of the blocked end, creation of flaps, bleeding control, repositioning of flaps to create a new opening, chromotubation (if performed), irrigation of the abdominal cavity, removal of packing, and closure of the abdominal incision.

IMPORTANT For laparoscopic approach, use 58673. For excision or destruction of endometriomas, open method, see 49203-49205, 58957, 58958. For pelvic laparotomy, use 49000.For paracentesis, see 49082, 49083, 49084. For secondary closure of abdominal wall evisceration or disruption, use 49900. For fulguration or excision of lesions, laparoscopic approach, use 58662.

In simple words: This surgery opens a blocked fallopian tube so eggs can travel from the ovary to the uterus.The doctor makes a cut in the lower abdomen, opens the tube, and makes sure it's open again.

Salpingostomy, also known as salpingoneostomy, is a surgical procedure to create a new opening in the distal end of a fallopian tube that is closed or blocked.The procedure is typically performed via an abdominal incision. The surgeon inspects the abdominal cavity, uterus, fallopian tubes, and ovaries.The blocked end of the fallopian tube is isolated, incised using scissors, electrosurgery, or a laser, and reshaped to create multiple flaps. Bleeding is controlled, and the flaps are repositioned to create a new opening. Chromotubation (dye injection) may be used to confirm tubal patency. The abdominal cavity is irrigated, and the incision is closed.

Example 1: A 32-year-old woman presents with infertility and history of pelvic inflammatory disease.A salpingostomy is performed to restore tubal patency., A 28-year-old woman with a history of ectopic pregnancy undergoes a salpingostomy to repair tubal damage following salpingectomy. The procedure is performed during laparotomy for other gynecological procedures., A 35-year-old woman who previously underwent tubal ligation requests reversal.A salpingostomy is performed bilaterally, and modifier 50 is added to indicate bilateral procedures.

* Preoperative history and physical examination* Operative report detailing the procedure, including type of incision, method of tubal opening creation, and chromotubation results (if performed).* Postoperative course notes documenting recovery and complications.* Imaging studies (e.g., hysterosalpingogram, ultrasound) to document tubal patency before and after the procedure.* Pathology report if tissue samples were collected during the surgery.

** Always ensure complete and accurate clinical documentation to support the medical necessity and accurate coding of 58770.Consult the most up-to-date CPT codebook and payer-specific guidelines for current coding and reimbursement information.

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