Summary & Overview
CPT 58740: Lysis of Adnexal Adhesions via Abdominal Incision
CPT code 58740 denotes open surgical lysis of adhesions involving the fallopian tubes and/or ovaries performed through an abdominal incision. The code captures an operative gynecologic procedure that can address pelvic pain, infertility, or mechanical obstruction by restoring adnexal anatomy. Nationally, accurate coding for this procedure matters for clinical documentation, appropriate facility and surgeon reimbursement, and tracking utilization of operative versus minimally invasive approaches.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for adnexal adhesion lysis, common sites of service, and typical procedural setting. The publication outlines benchmarks and utilization patterns where available, highlights relevant policy considerations that affect coverage and site-of-service decisions, and summarizes coding nuances that influence claim adjudication.
This analysis helps clinicians, billers, and policy stakeholders understand the clinical role of 58740, typical care settings, and the payer landscape affecting access and reimbursement. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 58740 describes a surgical procedure in which the provider removes adhesions from around the fallopian tubes and/or the ovaries through an abdominal incision. This procedure is an operative gynecologic intervention to restore or improve pelvic anatomy by lysing adnexal adhesions.
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Service type: Open surgical lysis of adnexal adhesions (operative gynecology)
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Typical site of service: Hospital operating room or ambulatory surgery center via an abdominal incision
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Clinical & Coding Specifications
Clinical Context
A 33-year-old female with a history of prior pelvic surgery presents with chronic pelvic pain and difficulty conceiving. Imaging and diagnostic laparoscopy show dense peri-tubal and peri-ovarian adhesions impairing tubal mobility. The surgical team plans an open abdominal approach to lysis of adhesions (adhesiolysis) due to extensive scarring that is not safely amenable to minimally invasive techniques.
Preoperative workflow includes informed consent, review of prior operative reports and imaging, anesthesia evaluation, and baseline labs. Intraoperative steps include midline or Pfannenstiel abdominal incision, exposure of pelvis, careful sharp and blunt dissection to free adhesions from the fallopian tubes and ovaries while minimizing thermal injury, assessment of tubal patency, hemostasis, and abdominal closure. Postoperative workflow includes monitoring in the recovery area, pain management, venous thromboembolism prophylaxis as indicated, wound care instructions, and a follow-up visit to assess healing and fertility counseling as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Office or other outpatient visit for evaluation and management by the performing physician | Use when the primary surgeon personally performs the significant portion of the procedure and an E/M is reported with the global period rules applicable. |