Summary & Overview
CPT 59151: Laparoscopic Adnexal Removal for Ectopic Pregnancy
CPT code 59151 identifies a laparoscopic gynecologic surgery that removes a fallopian tube and/or ovary while managing an ectopic pregnancy. This code captures a clinically urgent procedure performed when the ectopic pregnancy is embedded in adnexal structures or when rupture has occurred, necessitating adnexal resection. Nationally, accurate coding of this service affects inpatient and outpatient surgical reporting, quality measurement, and payment for acute gynecologic care.
Key payers addressed 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. The publication also outlines typical billing elements tied to this service line, examples of related surgical scenarios, and the implications for claims processing and utilization monitoring.
The report is intended for billing specialists, hospital coding departments, and policy analysts who need clear guidance on the clinical intent and reporting context of CPT code 59151. It summarizes benchmarks where available, highlights policy and reimbursement topics relevant to acute gynecologic surgery, and situates the code within broader surgical and quality measurement frameworks. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 59151 describes a laparoscopic procedure in which the provider removes a fallopian tube and/or an ovary in addition to addressing an ectopic pregnancy. The procedure is performed when an ectopic pregnancy is embedded in or has caused significant damage to the fallopian tube or ovary, or when a ruptured tube necessitates removal of the affected structures.
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Service type: Minimally invasive gynecologic surgery for ectopic pregnancy management with adnexal removal
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Typical site of service: Hospital outpatient department or ambulatory surgery center; may occur in an inpatient setting if clinically indicated
Clinical & Coding Specifications
Clinical Context
A 29-year-old woman presents to the emergency department with acute lower abdominal pain, vaginal bleeding, and signs of hemodynamic instability. Transvaginal ultrasound demonstrates an extrauterine gestational sac within the left fallopian tube with active free fluid consistent with hemoperitoneum. The patient is taken emergently to the operating room for diagnostic laparoscopy. Intraoperative findings reveal a ruptured tubal ectopic pregnancy with severe tubal damage and active bleeding; the surgeon performs a laparoscopic salpingectomy with removal of the affected fallopian tube. Specimens are sent to pathology. The typical clinical workflow includes emergency assessment in ED, preoperative consent and labs, anesthetic evaluation, laparoscopic procedure in the OR, postoperative recovery and observation, pathology final report, and surgical follow-up for wound checks and counseling on future fertility options.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when operative complexity or time is substantially greater than typical for 59151 and well-documented. |
23 |