Summary & Overview
CPT 58345: Transcervical Tubal Catheterization for Infertility
CPT code 58345 denotes transcervical tubal catheterization used to diagnose and treat fallopian tube obstruction in infertility care. Nationally, this procedure is an important minimally invasive option that can restore tubal patency without laparotomy, reduce time to conception for selected patients, and interface with assisted reproductive services. Payers commonly covering this service include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
This publication provides a concise synthesis of clinical context, payer coverage considerations, and operational benchmarks for CPT code 58345. Readers will find a description of the procedure and its typical facility settings, common billing modifiers and coding considerations, and an outline of what to expect from major payers regarding coverage and prior authorization practices. The summary also highlights where policy updates or variations in coverage may affect billing workflows and referral patterns. Data not available in the input for specific reimbursement rates or regional utilization is noted as unavailable.
Billing Code Overview
CPT code 58345 describes a transcervical fallopian tube catheterization performed to diagnose and treat tubal occlusion as a cause of infertility. The procedure involves introducing a catheter through the cervix into the fallopian tube, often with injection of contrast material and fluoroscopic imaging (a hysterosalpingogram) to evaluate and clear blockages.
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Service type: Diagnostic and therapeutic tubal catheterization for infertility
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Typical site of service: Outpatient radiology or ambulatory surgical center with fluoroscopy capabilities
Clinical & Coding Specifications
Clinical Context
A 33-year-old woman with 18 months of infertility, regular menses, and no prior pelvic surgery is scheduled for fallopian tube catheterization with hysterosalpingography guidance to evaluate and potentially clear proximal tubal occlusion. The patient presents to the outpatient radiology suite or ambulatory surgery center after pre-procedure counseling and informed consent. Intravenous access is established; a pelvic speculum exam and cervical cleansing are performed. A transcervical catheter is introduced through the cervical canal into the uterine cavity, and contrast material is injected under fluoroscopy to outline the uterine cavity and fallopian tubes. Images are obtained (hysterosalpingogram). If a proximal tubal blockage is identified, gentle pressure or selective tubal catheterization with microcatheters may be performed to attempt recanalization and clear the obstruction. Post-procedure, the patient is observed for allergic reaction, bleeding, or pelvic pain and discharged with post-procedure instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier/unspecified | Data not typically used as a distinct CMS modifier; not commonly appended to claims |
11 | Office or other outpatient evaluation and management performed by the billing provider |