2025 CPT code 58662
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Laparoscopic surgical procedure involving fulguration or excision of lesions on the ovary, pelvic viscera, or peritoneal surface.
Modifiers may be applicable depending on the circumstances of the procedure.Modifier 22 (Increased procedural services) may be used if the work required exceeds typical time, while other modifiers might be needed based on additional services or surgical circumstances.
Medical necessity is established by clinical symptoms (e.g., pelvic pain, infertility) and diagnostic findings (e.g., imaging studies, laparoscopy) indicating the presence of lesions requiring excision or fulguration.The procedure should be medically necessary for the patient's condition.
The clinical responsibility includes preoperative assessment, administering anesthesia, performing the laparoscopic procedure (including insufflation, trocar placement, lesion excision or fulguration, and organ manipulation), hemostasis, irrigation, and closure of trocar sites.Postoperative care, including follow-up, is also the responsibility of the surgeon. The surgeon might work with assistants, anesthesiologists, and pathologists.
In simple words: This code covers a minimally invasive surgery where a doctor uses a small camera and instruments inserted through tiny incisions in the abdomen to remove or destroy abnormal growths on the ovaries, uterus, or nearby organs.
This CPT code encompasses laparoscopic surgical procedures where lesions (e.g., cysts, tumors, endometrial implants) on the ovary, pelvic viscera (including the uterus, fallopian tubes, and surrounding structures), or peritoneal surface are destroyed (fulguration) or removed (excision) using any method (e.g., electrosurgery, laser, scissors).The procedure typically involves creating a pneumoperitoneum via insufflation of CO2, inserting trocars for instrument access, and manipulating the pelvic organs for optimal visualization and surgical access.Post-operative steps such as irrigation, deflation, and trocar site closure are also included.
Example 1: A 35-year-old female presents with pelvic pain and irregular menstrual cycles. Laparoscopic examination reveals multiple small endometrial implants on the peritoneum and a 3cm endometrioma on the right ovary.The surgeon performs laparoscopic excision of the endometrioma and fulguration of the peritoneal implants., A 42-year-old female undergoes a laparoscopic procedure for suspected ovarian cyst. Intraoperatively, a 5cm cystic lesion is found on the left ovary along with several smaller lesions on the uterine serosa.The surgeon excises the large cyst and performs laparoscopic fulguration of the smaller lesions on the uterine surface., A 28-year-old female with a history of endometriosis undergoes a laparoscopic surgery to remove a large endometrioma on her right ovary and resect several adhesions around her fallopian tubes. The surgeon uses electrosurgery to fulgurate the adhesions and excise the endometrioma.
Comprehensive operative notes detailing the surgical approach, location and size of lesions, methods of excision or fulguration, any complications, specimens removed, and post-operative course.Pre-operative diagnostic imaging (e.g., ultrasound, MRI) should support the diagnosis and surgical findings. Pathology reports are necessary to confirm the nature of removed tissue.
** The time spent on the procedure is a factor that must be considered when determining if additional modifier(s) are needed. The 80 minutes noted in the provided text is an average, and actual time will vary based on the number and type of lesions and the surgeon's technique. Always verify with official guidelines and payer policies for any billing and coding uncertainties.
- Revenue Code: P5E (AMBULATORY PROCEDURES - OTHER)
- RVU: The relative value units (RVUs) for this code vary based on geographic location, facility type, and other factors.Consult the CMS Physician Fee Schedule for the most current RVU values and payment rates.
- Global Days: The global period for this procedure varies depending on the complexity and extent of the surgery.It is generally included in the code itself, but may require additional documentation to clarify any additional postoperative visits or services.
- Payment Status: Active
- Modifier TC rule: Technical component (TC) modifiers may apply depending on whether the physician performed the procedure or if the technical portion was handled by another provider.Refer to the specific payer guidelines for more details.
- Fee Schedule: Historical fee schedule data is not provided here; consult the CMS Physician Fee Schedule and other relevant databases for historical payment information.
- Specialties:Obstetrics and Gynecology, General Surgery
- Place of Service:Ambulatory Surgical Center, Hospital (Inpatient and Outpatient), Office