Summary & Overview
CPT 58673: Laparoscopic Creation of Fallopian Tube Opening
CPT code 58673 identifies a laparoscopic gynecologic procedure that creates a new opening at the distal end of the fallopian tube to permit passage of ova into the uterus. Nationally, this code is relevant for fertility-related surgical care, affecting coverage determinations, surgical coding accuracy, and claims adjudication for minimally invasive reproductive procedures. The code captures a specific operative technique distinct from open tubal surgery and other tubal repair procedures.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context, common sites of service, and the administrative considerations tied to this procedure. The publication summarizes typical billing scenarios, common modifiers reported with this service, and where this code fits among related gynecologic surgical codes. It also outlines benchmarks and policy-relevant points that influence coverage and payment for laparoscopic tubal recanalization.
This summary is intended for coding professionals, practice managers, and policy analysts seeking concise guidance on the clinical meaning, billing use, and payer landscape for CPT code 58673. Data not available in the input is explicitly noted where applicable.
Billing Code Overview
CPT code 58673 describes a laparoscopic procedure to create a new opening at the end of the fallopian tube so that eggs from the ovary can pass into the uterus. This procedure is a gynecologic, fertility-related surgical intervention performed using a laparoscope.
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Service type: Minimally invasive gynecologic surgery (laparoscopic tubal recanalization or neosalpingostomy)
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Typical site of service: Hospital outpatient department or ambulatory surgery center where laparoscopic gynecologic procedures are performed.
Clinical & Coding Specifications
Clinical Context
A 32-year-old woman with symptomatic proximal tubal occlusion and infertility undergoes diagnostic laparoscopy with operative tubal recanalization to restore patency of the distal fallopian tube. The patient presents after 18 months of unsuccessful attempts to conceive and a hysterosalpingogram demonstrating occlusion at the fimbriated end of the right fallopian tube. Preoperative steps include informed consent, anesthesia evaluation (general anesthesia typical), prophylactic antibiotics per facility protocol, and positioning in lithotomy for combined laparoscopy and possible hysteroscopic evaluation.
Intraoperative workflow: a gynecologic surgeon inserts a laparoscope through a small umbilical incision, inspects the pelvis, and identifies a blocked or scarred tubal ostium. Under laparoscopic visualization, the surgeon uses microsurgical techniques — instruments such as micro-scissors, fine graspers, and possibly a balloon catheter or microcatheter under saline or chromopertubation guidance — to create a new opening at the fimbrial end of the tube. Chromopertubation (dye test) confirms patency. Hemostasis is achieved, incisions closed, and the patient is recovered in the post-anesthesia care unit with routine postoperative counseling about activity restrictions, signs of infection, and follow-up for fertility planning.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to create the neostomy is substantially greater than typical (extensive adhesiolysis, prolonged time). |