Summary & Overview
CPT 58900: Ovarian Biopsy via Vaginal or Abdominal Approach
CPT code 58900 denotes surgical biopsy of one or both ovaries via a vaginal or abdominal approach to obtain tissue for diagnostic evaluation. Nationally, this code captures a focused surgical service used in the diagnosis of ovarian pathology, including mass evaluation and suspected malignancy. Accurate coding of 58900 affects clinical documentation, procedure tracking, and payer adjudication for gynecologic surgical services.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, common sites of service, and payer coverage considerations for ovarian biopsy procedures. The publication provides benchmarks where available, summarizes relevant policy and coding guidance updates, and outlines typical service line implications for surgical and obstetrics-gynecology practices.
The report is intended for revenue cycle professionals, clinicians, and policy analysts seeking a national perspective on coding and coverage for ovarian biopsy procedures. Data not available in the input will be identified as such in supporting tables and appendices.
Billing Code Overview
CPT code 58900 describes a procedure in which the provider obtains a tissue sample from one or both ovaries for diagnostic purposes. The sampling may be performed through a vaginal or abdominal approach, depending on clinical indication and provider judgment.
Service type: Ovarian biopsy / diagnostic ovarian tissue sampling
Typical site of service: Ambulatory surgical center, hospital outpatient department, or inpatient surgical setting
Clinical & Coding Specifications
Clinical Context
A 38-year-old woman presents with persistent unilateral pelvic pain and an adnexal mass identified on transvaginal ultrasound. Tumor markers are equivocal and the clinician recommends an ovarian biopsy to obtain histologic diagnosis prior to definitive surgical planning. The patient is counseled about approaches; the provider elects a transvaginal ultrasound-guided core biopsy in the outpatient procedure suite under conscious sedation. The clinical workflow includes pre-procedure consent and review of imaging, sterile preparation, local anesthesia and/or conscious sedation, ultrasound guidance to target the lesion, obtaining one or more tissue cores from one or both ovaries, hemostasis verification, pathology specimen labeling and sending for histopathology, and post-procedure recovery with discharge instructions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician’s professional interpretation/biopsy performance separate from facility technical services |
50 | Bilateral procedure | Use when biopsy specimens are taken from both ovaries during the same operative session |