Summary & Overview
CPT 58350: Chromotubation for Fallopian Tube Patency Assessment
CPT code 58350 represents chromotubation, a diagnostic procedure in which dye is injected into the fallopian tubes to determine tubal patency. This code is relevant nationally because tubal patency assessment is a key element of infertility workups and intraoperative evaluations during gynecologic surgery. Proper coding and clinical documentation support appropriate care delivery and payer adjudication for a commonly performed diagnostic procedure in reproductive medicine.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical service settings, and payer coverage considerations. The publication outlines common billing modifiers (listed separately), typical sites of service such as the operating room or ambulatory surgery center, and what to expect in claims processing for a diagnostic tubal patency assessment.
This piece provides benchmarks and policy context relevant to national payer practices, clinical indications for chromotubation, and operational considerations for facilities and clinicians performing the procedure. Data not available in the input are explicitly noted where applicable.
Billing Code Overview
CPT code 58350 describes a diagnostic procedure in which a provider injects dye into the oviduct (fallopian tube) to assess tubal patency, commonly known as chromotubation. This procedure is typically performed as part of infertility evaluation or intraoperative assessment during gynecologic surgery.
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Service type: Diagnostic radiologic/gynecologic procedure to evaluate fallopian tube patency
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Typical site of service: Operating room, ambulatory surgery center, or specialized gynecologic procedure suite where surgical or hysteroscopic access to the uterus and fallopian tubes is available
Clinical & Coding Specifications
Clinical Context
A 32-year-old woman with a 2-year history of infertility presents to the reproductive endocrinology clinic for evaluation. She has regular menses, a normal semen analysis from her partner, and prior hysterosalpingogram showing unclear tubal patency. The clinician schedules a diagnostic laparoscopy with chromotubation using dye to assess fallopian tube patency. The procedure is performed in an ambulatory surgery center under general anesthesia. The surgeon introduces methylene blue or indigo carmine dye through the cervix and observes spill from the distal fallopian tubes laparoscopically to confirm patency. If unilateral or bilateral obstruction is identified, the operative plan is documented and discussed with the patient, and additional procedures (e.g., lysis of adhesions) may be scheduled separately. Billing uses 58350 for the chromotubation component when performed as part of the laparoscopy or tubal evaluation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management service | Use when a distinct E/M is provided on the same day as 58350 prior to the procedure |