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tubaligation during c/section

Pat Posted Mon 02nd of March, 2020 12:00:15 PM
what is the appropriate code to use when doing a tubaligation during a c/section?
SuperCoder Answered Tue 03rd of March, 2020 02:51:39 AM

Hi Pat,

CPT 58611 {Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery} is appropriate to bill for the tubal ligation during c-sec.

In this add–on procedure, the provider performs a cesarean delivery, and after she closes the uterus with sutures, she performs a sterilization procedure to prevent pregnancy.

To begin, the provider grasps the fallopian tube with a clamp and passes a hemostat through the part of the fallopian tube that has a limited blood supply. She then places sutures through the opening she creates with the hemostat and ties the tube in two locations leaving the ends of the suture thread long. Next, she incises the section between the two sutures. The provider then usually removes a portion of the tube and sends it to the laboratory to confirm removal of a section of the tube.

Next, she uses a hemostat to make a hole into the muscular layer of the uterus. She then takes the long thread ends of the suture in the tube closest to the hole and threads them into a needle. She passes the needle into the hole and exits the needle to the outside of the uterus. She repeats this again so there are two suture ends. Then she ties the two sutures together, buries the end of the fallopian tube into the hole, and sutures the uterine lining closed over the hole and tube. The provider then checks for bleeding and obtains hemostasis. Finally, she closes the abdominal incision that was made to begin the cesarean procedure.

Make sure to report this add–on code (58611) in addition to a primary procedure code.

Hope this helps!

Pat Posted Tue 03rd of March, 2020 11:14:36 AM
What is the difference between this and using 58700-
SuperCoder Answered Wed 04th of March, 2020 03:29:05 AM

Hi Pat,

Hope you are keeping well.

In procedure 58700 {Salpingectomy, complete or partial, unilateral or bilateral (separate procedure)}, the provider removes all or part of a fallopian tube on one or both sides. The provider performs the procedure via an abdominal incision. The provider incises the lower abdomen just above the pubic bone, then incises the peritoneum and explores the abdomen. The provider then makes another incision to expose the broad ligament. Once he exposes the broad ligament, the provider dissects the fallopian tube away from the ligament and removes the tube from the abdomen. He repeats this procedure for the other fallopian tube if performing a bilateral salpingectomy.

Whereas, in the procedure 58611 Ligation or transection of fallopian tube(s) being performed during the time of cesarean delivery or intra-abdominal surgery, and this procedure is not a separate procedure, it can only be billed in addition to code for primary procedure. Clinically, after the provider delivers a baby via a cesarean incision and after closer of the uterine incision, the provider ties off or incises one or both of the fallopian tubes to prevent a future pregnancy.

Hope this helps!

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