Summary & Overview
CPT 58660: Laparoscopic Lysis of Adhesions, Tubal/Ovarian
CPT code 58660 denotes a laparoscopic lysis of adhesions procedure in which a provider removes adhesions surrounding the fallopian tubes and ovaries via a laparoscope. This minimally invasive gynecologic surgery is commonly used to treat pelvic pain, infertility related to tubal occlusion, or pelvic adhesive disease. Nationally, correct coding for 58660 affects surgical quality reporting, reimbursement for ambulatory and hospital-based gynecologic services, and resource planning for minimally invasive pelvic surgery.
Key payers discussed in this publication include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise clinical context for the procedure, typical sites of service, and an overview of common modifiers associated with surgical billing. The report outlines benchmarks for utilization and reimbursement practices where available, highlights relevant coding considerations, and summarizes policy or coverage updates that commonly affect laparoscopic gynecologic procedures. The content is aimed at billing professionals, practice managers, and health policy analysts seeking a practical reference for CPT code 58660 and its role in gynecologic surgical services.
Billing Code Overview
CPT code 58660 describes a laparoscopic lysis of adhesions targeting adhesions around the fallopian tubes and ovaries. The procedure is performed through a laparoscope, indicating a minimally invasive surgical approach.
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Service type: Laparoscopic adhesion removal (pelvic)
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Typical site of service: Ambulatory surgery center or hospital operating room for minimally invasive gynecologic surgery
Clinical & Coding Specifications
Clinical Context
A 34-year-old woman with a history of prior pelvic surgery and chronic pelvic pain presents with infertility and suspected tubal factor disease. Imaging and hysterosalpingography suggest peritubal adhesions limiting tubal patency. The gynecologic surgeon schedules a diagnostic laparoscopy with planned lysis of adhesions. In the operating room under general anesthesia, a laparoscope and ancillary ports are placed. The surgeon inspects the pelvis, identifies filmy and dense adhesions involving the fallopian tubes and ovaries, and performs careful sharp and blunt dissection with electrosurgical energy as needed to restore normal anatomic relationships and optimize tubal mobility. Hemostasis is achieved, the abdomen is irrigated, and ports are removed. The procedure is billed as 58660 for laparoscopic lysis of adhesions from fallopian tube(s) and ovarian surfaces. Typical site of service is an ambulatory surgical center or hospital outpatient operating room. Preoperative documentation includes infertility evaluation, prior operative history, and informed consent; intraoperative notes document findings, techniques, time, instruments, and any concurrent procedures; postoperative documentation includes recovery instructions and follow-up planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when documented work, time, and complexity substantially exceed typical for . |