Summary & Overview
CPT 58750: Tubotubal Anastomosis (Tubal Reversal Surgery)
CPT code 58750 represents tubotubal anastomosis, a surgical reversal of prior tubal sterilization performed through an abdominal incision to restore fertility. This procedure is clinically significant nationwide because it addresses patients seeking reversal of sterilization and involves operative and postoperative resource use that affects hospital and ambulatory surgical center workflows, coding, and coverage decisions. Key payers typically referenced in national analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise clinical and coding overview, payer coverage perspectives, and benchmarks where available. The content covers the clinical intent of the procedure, typical sites of service, common modifiers observed in billing, and practical considerations for documentation and claim submission. Policy updates and coverage nuances that influence payment and prior authorization practices are summarized, as well as operational implications for surgical scheduling and postoperative care. Data specifics such as associated taxonomies, ICD-10 diagnoses, and related codes are noted where available; if those elements are not provided in the input, they are listed as not available. This summary is written for a national audience interested in clinical coding, revenue cycle impact, and payer coverage context for tubal reversal surgery.
Billing Code Overview
CPT code 58750 describes a tubotubal anastomosis, a surgical procedure in which the provider sutures together the segment of a fallopian tube that was previously transected during sterilization. The operation is performed via an abdominal incision to reestablish tubal patency and the patient’s potential to become pregnant.
Service type: Reconstructive/reversal tubal surgery
Typical site of service: Hospital operating room or ambulatory surgical center via abdominal approach
Clinical & Coding Specifications
Clinical Context
A 36-year-old woman presents to the gynecologic surgery clinic seeking restoration of fertility after prior tubal sterilization by tubal ligation performed 8 years earlier. She reports regular menses, no contraindications to pregnancy, and her partner has a normal semen analysis. Pelvic imaging and hysterosalpingography demonstrate patent distal fallopian tube segments with a proximal transection site amenable to reanastomosis. The planned procedure is a tubotubal anastomosis performed through an abdominal incision under general anesthesia to reapproximate the transected tubal segments and restore tubal continuity.
Preoperative workflow includes history and physical, informed consent discussing risks (bleeding, infection, ectopic pregnancy), baseline labs, and anesthesia evaluation. Intraoperative steps include abdominal entry (mini-laparotomy or low transverse incision), identification and mobilization of proximal and distal tubal segments, microsurgical spatulated end-to-end anastomosis with fine suture, patency testing (chromotubation), and layered abdominal closure. Postoperative care involves recovery from anesthesia, pain control, discharge instructions regarding activity restrictions, and follow-up for wound check and assessment of fertility outcomes over subsequent months.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work or complexity substantially exceeds usual for (document justification). |