Summary & Overview
CPT 58752: Tubouterine Implantation via Abdominal Incision
CPT code 58752 represents tubouterine implantation performed via an abdominal incision to reimplant the fallopian tube into the upper uterus. This reconstructive sterilization reversal or tubal reanastomosis–related procedure is clinically significant for fertility restoration and for surgical services billing across hospital and ambulatory settings. Nationally, accurate coding of 58752 affects claims adjudication, surgical quality measurement, and coverage determinations for fertility-restoration procedures.
Key payers analyzed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical intent of the code, typical sites of service, common modifiers used in claims, and the payer mix represented in the analysis. The publication outlines reimbursement benchmarks, billing nuances arising from an open abdominal approach versus minimally invasive alternatives, and policy updates relevant to payer coverage and medical necessity determinations.
This summary helps billing managers, surgeons, and policy analysts understand where 58752 fits within reproductive surgery coding, what to expect from payer coverage patterns, and which clinical and billing elements typically drive claim outcomes.
Billing Code Overview
CPT code 58752 describes a tubouterine implantation performed via an abdominal incision. In this procedure, the provider sutures the fallopian tube directly into the upper portion of the uterus to reestablish tubouterine continuity and the patient’s potential to become pregnant.
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Service type: Reconstructive tubal surgery (tubal reimplantation) performed through an open abdominal approach
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Typical site of service: Inpatient or outpatient hospital surgical setting or ambulatory surgery center with an abdominal incision required
Clinical & Coding Specifications
Clinical Context
A 32-year-old woman with a history of distal tubal injury from prior pelvic infection presents with infertility after 18 months of unprotected intercourse. Imaging and hysterosalpingography demonstrate tubouterine scarring with proximal tubal obstruction near the uterotubal junction. After counseling and infertility workup, the gynecologic surgeon schedules a tubouterine implantation to reestablish tubal continuity.
The clinical workflow: preoperative evaluation includes history, physical exam, informed consent, baseline labs, and pelvic imaging. On the day of surgery the patient undergoes general anesthesia. Via an abdominal incision (usually lower midline or Pfannenstiel), the surgeon mobilizes the affected fallopian tube, excises scar tissue at the uterotubal junction, and sutures the tubal mucosa to the uterine myometrium/cavity to create a patent tubouterine anastomosis. Hemostasis is ensured, and tubal patency may be confirmed intraoperatively with chromotubation. The patient recovers in the postoperative area with discharge planning that includes postoperative activity restrictions, analgesia, and follow-up fertility assessment.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier reported | Default when no specific modifier applies |
11 |