Summary & Overview
CPT 58565: Hysteroscopic Fallopian Tube Sterilization with Coil Implants
CPT code 58565 designates a hysteroscopic fallopian tube sterilization procedure in which coils are placed into both tubes at their uterine junction to induce occlusion and prevent pregnancy. This minimally invasive, hysteroscopically delivered approach matters nationally as an alternative to laparoscopic or transcervical sterilization techniques, affecting surgical practice patterns, device utilization, and payer coverage decisions for permanent contraception.
Key payers referenced in national coverage discussions include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a clinical and billing-focused overview of the procedure, typical sites of service, and the implications for coding and reimbursement workflows. The publication summarizes common modifier usage (input-provided list), outlines the clinical context of hysteroscopic sterilization versus other sterilization methods, and highlights what to expect in claims processing given the service setting.
The analysis provides benchmarks and policy context where available and identifies gaps in the supplied input. Data not available in the input is noted explicitly. This resource is intended for billing managers, surgical schedulers, and policy analysts seeking a concise reference on CPT code 58565, its clinical application, and payer relevance in the United States.
Billing Code Overview
CPT code 58565 describes a hysteroscopically guided fallopian tube sterilization procedure in which coil implants are placed into both fallopian tubes at their junction with the uterus. The implanted coils induce scar tissue formation that eventually occludes the tubes and prevents pregnancy.
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Service type: Minimally invasive gynecologic sterilization procedure performed via hysteroscopy
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Typical site of service: Outpatient surgical center or hospital ambulatory surgery setting where hysteroscopic procedures are performed
Clinical & Coding Specifications
Clinical Context
A 35-year-old woman elects permanent sterilization following completion of childbearing. She presents to the ambulatory surgical center after preoperative counseling and informed consent. Preoperative evaluation confirms no active pelvic infection and a negative pregnancy test. On the day of service, the patient undergoes hysteroscopic transcervical placement of bilateral intratubal coil implants using a hysteroscope and fluoroscopic or hysteroscopic visualization. Local anesthesia with conscious sedation or general anesthesia may be used depending on patient and facility practices. The procedure typically lasts 15–45 minutes. Postprocedure monitoring is performed in the recovery area until discharge criteria are met. Follow-up is scheduled to confirm tubal occlusion (often by hysterosalpingogram at 3 months) and to address any complications such as pelvic pain, bleeding, or device-related issues.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | Default or no modifier | Use when no additional modifier applies to the service |
11 | Primary procedure | Use when this service is the principal procedure performed during the encounter |