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2025 CPT code 58605

Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization (separate procedure).

Consult the current CPT manual for detailed coding guidelines and specific instructions concerning modifiers.Careful consideration is required when deciding on the need for modifiers based on the specific scenario and timing of the procedure.

Modifiers 79 (Unrelated procedure or service by the same physician during the postoperative period) and 59 (Distinct procedural service) may be applicable depending on the timing of the procedure relative to the vaginal delivery.Documentation must support the modifier used.

Medical necessity for this procedure is usually based on the patient's informed decision to elect permanent contraception after vaginal delivery.Some payers may require specific documentation of the patient's understanding of alternative contraceptive methods.

The procedure requires a surgeon's expertise in gynecological surgery.The surgeon is responsible for pre-operative assessment, surgical technique, post-operative care and follow-up.

IMPORTANT:For laparoscopic procedures, use 58670 or 58671.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 involves tying off or cutting one or both fallopian tubes to prevent future pregnancies. It is done after a vaginal delivery, while the mother is still in the hospital, as a separate procedure.

This CPT code describes the surgical procedure of ligating or transecting one or both fallopian tubes, using either an abdominal or vaginal approach. This procedure is specifically performed postpartum, during the same hospitalization as the vaginal delivery, as a separate procedure. The procedure may be unilateral (one tube) or bilateral (both tubes).

Example 1: A patient undergoes a vaginal delivery.Postpartum, the patient elects to have a bilateral tubal ligation to prevent future pregnancies. The procedure is performed vaginally under general anesthesia., A patient delivers vaginally.The following day, while still hospitalized, the patient chooses to undergo a unilateral tubal ligation. The surgeon utilizes an abdominal approach., Following a vaginal delivery, a patient is diagnosed with postpartum hemorrhage requiring an emergency abdominal approach for bilateral tubal ligation.The hemorrhage is managed concurrently with the ligation.

* Detailed operative report, including approach (abdominal or vaginal), laterality (unilateral or bilateral), and specific surgical technique.* Preoperative assessment documenting patient's informed consent, medical history, and physical examination findings.* Postoperative progress notes documenting the patient's recovery, including any complications.* Pathology report if tissue samples are obtained.

** This code should only be reported when the procedure is performed as a separate procedure during the same hospitalization as the vaginal delivery.Do not confuse this with tubal ligation performed at the time of Cesarean section.

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