How to Code Tubal Ligation With Cesarean and Other Top Tips

coding postpartum tubal ligation

CPT® provides a surprising number of options for coding tubal ligations, informally known as a patient having her tubes tied. I’ve pulled three tips from one of our more popular Ob-Gyn Coding Alert articles that provide some expert insights into getting these claims right, focusing on some areas you may not have considered.

Helpful hint: Remember to use Z30.2 (Encounter for sterilization) to support your tubal ligation code, regardless of type.

1. Confirm Cesarean Combo Gets Paid

Tubal ligation is a sterilization procedure that keeps a woman from conceiving by preventing the egg from moving down the fallopian tube. When a patient undergoes tubal ligation at the same session as a Cesarean delivery, you may know to add +58611 (Ligation or transection of fallopian tube[s] when done at the time of cesarean delivery or intra-abdominal surgery [not a separate procedure] [List separately in addition to code for primary procedure]) to your claim.

But have you ever checked whether payers reimburse you for it? Insurers may claim that the ligation didn’t require enough work to be paid separately from the C-section.

If your payers aren’t recognizing the extra effort tubal ligation after a Cesarean requires, your practice should make a point of including this service in your next contract negotiation. You can use the Medicare RVUs for +58611 as a guide and to help support your argument for separate payment.

2. Tell the Story for Postpartum Ligation

Postpartum tubal ligation following a vaginal delivery may occur on a different date than the birth but during the same hospital stay.

Experts advise appending modifier 79 (Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period) to the tubal ligation code, such as 58605 (Ligation or transection of fallopian tube[s], abdominal or vaginal approach, postpartum, unilateral or bilateral, during same hospitalization [separate procedure]).

3. Don’t Let ‘Minilaparoscopic’ Get You Off Track

CPT® provides laparoscopic codes 58670 (fulguration of oviducts) and 58671 (occlusion of oviducts).

But what if the documentation refers to a “minilaparoscopic tubal”? The answer is that the same codes apply: 58670 and 58671.

How About You?

Do you code ob-gyn procedures? Which ligation code do you use most often?

About 

Deborah concentrates on coding and compliance for radiology and cardiology, including the tricky world of interventional procedures, as well as oncology and hematology. Since joining The Coding Institute in 2004, she’s also covered the ins and outs of coding for orthopedics, audiology, skilled nursing facilities (SNFs), and more.

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