2025 CPT code 58673
Effective Date: N/A Surgery - Surgical Procedures on the Female Genital System Feed
Laparoscopy, surgical; with salpingostomy (salpingoneostomy)
Modifiers such as 22 (Increased Procedural Services), 50 (Bilateral Procedure), 52 (Reduced Services), 53 (Discontinued Procedure), and others may be applicable depending on the specific circumstances.
Medical necessity must be established by documenting the diagnosis justifying the procedure, such as distal tubal blockage, hydrosalpinx, or previous tubal ligation reversal, and the impact on fertility.The documentation should demonstrate that less invasive treatments have been considered or are not suitable.
The physician is responsible for all aspects of the procedure, including patient positioning, anesthesia, incisions, laparoscopic insertion, creating the new tubal opening, chromotubation, and closure. They also manage any complications.
In simple words: A surgeon uses a small camera and tiny tools inserted through small cuts in the belly to create a new opening in the end of the fallopian tube. This allows eggs to travel from the ovary to the uterus, improving chances of pregnancy.
This code describes a laparoscopic procedure where a new opening is created at the end of the fallopian tube. This allows eggs to pass from the ovary into the uterus.The procedure involves placing the patient in a dorsal lithotomy position, administering general anesthesia, and inserting a uterine manipulator. A laparoscope is inserted through an incision near the belly button, and the abdomen is insufflated with CO2.Small incisions are made for trocars to allow surgical tools to be used. In robotic surgery, the robot is docked to the laparoscope. The surgeon isolates the distal end of the fallopian tube, creates a crosscut incision to form flaps, and folds the flaps back to create the new opening. Chromotubation confirms the opening, and then the abdomen is deflated, and incisions are closed.
Example 1: A 30-year-old woman with a history of ectopic pregnancy and distal tubal blockage undergoes a laparoscopic salpingostomy to restore tubal patency and improve fertility., A 35-year-old woman with hydrosalpinx (fluid-filled fallopian tube) undergoes a laparoscopic salpingostomy to remove the blockage and improve her chances of natural conception., A 28-year-old woman with a previous tubal ligation desires reversal and undergoes a laparoscopic salpingostomy to reopen the fallopian tube and restore fertility.
Documentation should include operative notes detailing the procedure, including the location and size of the incision, method used to create the new opening, confirmation of patency via chromotubation, and any complications. Pre-operative diagnostic reports, such as ultrasound or hysterosalpingogram (HSG), should also be included.
** Laparoscopic salpingostomy is a minimally invasive alternative to open surgery, offering potential benefits like reduced pain, faster recovery, and lower risk of infection. However, the success of the procedure in restoring fertility depends on various factors such as the patient's overall health, the extent of tubal damage, and the presence of other fertility issues.
- Revenue Code: P5E
- Specialties:Gynecology, Reproductive Endocrinology, Infertility
- Place of Service:Ambulatory Surgical Center, Hospital Outpatient, Inpatient Hospital