Summary & Overview
CPT 59150: Laparoscopic Conservative Management of Ectopic Pregnancy
CPT code 59150 identifies a laparoscopic, conservative surgical procedure to remove a small ectopic pregnancy from the fallopian tube or ovary, or to extract a fetus lodged in the pelvic cavity or the uterine cornu, while preserving the tube and ovary. This code is important nationally because ectopic pregnancy is a time-sensitive obstetric emergency that often requires skilled minimally invasive intervention; accurate coding affects clinical documentation, billing consistency, and quality measurement for gynecologic surgical care.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise clinical context for the procedure, expected sites of service, and common coding considerations. Readers will find benchmarks and typical billing practice notes, an overview of payer coverage patterns, and policy-relevant updates affecting minimally invasive gynecologic surgery coding. The content also highlights how CPT code 59150 fits into surgical service lines for obstetrics and gynecology and implications for facility versus professional billing. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 59150 describes a laparoscopic conservative management of an ectopic pregnancy or removal of a fetus from the pelvic cavity or uterine cornu without removal of the fallopian tube or ovary. The procedure involves making an incision or opening in the fallopian tube and/or ovary, or removing a fetus embedded in the uterine horn, using a laparoscope.
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Service type: Minimally invasive gynecologic surgical procedure for ectopic pregnancy/fetal removal
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Typical site of service: Hospital operating room or ambulatory surgical center (laparoscopic surgical suite)
Clinical & Coding Specifications
Clinical Context
A 29-year-old woman presents to the emergency department with acute right lower quadrant pain, vaginal bleeding, and a positive pregnancy test. Transvaginal ultrasound demonstrates a 2.5 cm adnexal mass adjacent to the right ovary with no intrauterine pregnancy identified, and rising serial beta-hCG levels consistent with a suspected tubal ectopic pregnancy. The patient is hemodynamically stable but symptomatic and declines medical management. After informed consent, the surgical team schedules a laparoscopic procedure under general anesthesia. In the operating room, the surgeon places trocars, inspects the pelvis, and identifies a small tubal ectopic pregnancy located in the ampullary region of the right fallopian tube. The surgeon performs a salpingostomy via laparoscopic incision into the tube, evacuates the trophoblastic tissue, ensures hemostasis, irrigates the pelvis, and closes port sites. The fallopian tube is preserved. Postoperative recovery includes monitoring of vital signs, serial beta-hCG to confirm declining levels, pain control, and counseling about future fertility and follow-up.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing separately for the physician’s professional portion in a global service split (rare for this laparoscopy but applicable if imaging interpretation or separate professional service applies). |