CPT Code 58600 Ligation or Transection of Fallopian Tube(s), Abdominal or Vaginal Approach, Unilateral or Bilateral

Accurate coding of sterilization procedures is crucial for OBGYN practices to ensure proper reimbursement and compliance. CPT 58600 is used to report laparoscopic or open ligation or transection of the fallopian tubes - commonly referred to as tubal ligation.

This code represents a permanent sterilization procedure performed for women who no longer desire fertility. Understanding how to use this code correctly is essential for accurate claim submission and preventing denials related to medical necessity or consent documentation.

CPT Code 58600 – Description of the Procedure

Official CPT Definition: “Ligation or transection of fallopian tube(s), abdominal or vaginal approach, unilateral or bilateral.”

This procedure involves cutting, tying, or otherwise blocking the fallopian tubes to prevent pregnancy. The physician can use an abdominal or vaginal approach, with or without a laparoscope.

Key Aspects:

• Purpose: Permanent sterilization.
• Approach: Abdominal (mini-laparotomy) or vaginal.
• Laterality: Can be unilateral or bilateral (most commonly bilateral).
• Techniques: May include Pomeroy, Irving, Parkland, or fimbriectomy methods.

It’s important to note that CPT 58600 covers the ligation or transection itself - not the method of occlusion (clips, cautery, etc.). If the sterilization is performed laparoscopically using a distinct code (such as 58671), use that instead.

When to Use CPT 58600

Use CPT 58600 when the physician performs a surgical tubal ligation or transection through an open abdominal incision (mini-laparotomy) or a vaginal approach.

Typical Clinical Indications Include:

• Elective sterilization (most common)
• Postpartum sterilization after cesarean or vaginal delivery
• Pathologic tube conditions (when not associated with other surgery)

Do not report CPT 58600 when:

• The procedure is performed laparoscopically (use 58671).
• Tubal occlusion is done using clips or bands (use 58615).
• Tubes are removed entirely (use 58700 – salpingectomy).
• Performed as part of another primary procedure (e.g., C-section) - report with modifier 59 only if distinct and medically necessary.

Coding Guidelines and Billing Rules

Proper billing and compliance depend on understanding bundled services and payer rules:

• Single code reporting: Report 58600 once per session, regardless of unilateral or bilateral ligation.
• Global period: 90 days.
• Setting: Hospital, ASC, or postpartum inpatient setting.
• Bundling: Routine surgical approach, anesthesia, and postoperative care are included.
• Modifier use: Apply only when sterilization is performed separately from another primary procedure.
• Consent requirements: Many payers, including Medicaid, require a signed sterilization consent (Form CMS-0069) dated at least 30 days before surgery.

Failure to include this consent is one of the most common reasons for claim denials on sterilization procedures.

Reimbursement and Coverage Information

Reimbursement for CPT 58600 depends on payer, setting, and region.

Approximate Medicare National Payment Averages:

• Physician (facility): $550–$700
• Hospital Outpatient Facility: $1,000–$1,300
• ASC Payment: $850–$1,100
• Global period: 90 days

Common ICD-10 Codes Supporting Medical Necessity:

• Z30.2 – Encounter for sterilization
• Z30.09 – Encounter for other general counseling on contraception
• N83.8 – Other noninflammatory disorders of fallopian tubes
• N70.11 – Chronic salpingitis, unilateral

Medicaid and commercial insurers may require prior authorization or additional documentation, especially for elective sterilization.

Modifier Use

Modifiers ensure accurate representation of surgical services:

• Modifier 51 – Multiple procedures in one session (if performed with unrelated surgery).
• Modifier 59 – Distinct procedural service when tubal ligation is unrelated to other procedures (e.g., postpartum ligation following C-section).
• Modifiers 54, 55, 56 – For shared care situations (surgical vs. postoperative management).
• Modifier 52 – Reduced service if only one tube is ligated due to prior removal or anatomical issue.

Always verify documentation supports modifier use, especially when billing alongside delivery procedures.

Documentation Requirements

To support CPT 58600 and ensure compliance, include:

• Patient’s consent for sterilization (signed and dated, meeting CMS requirements).
• Indication: Elective or medical sterilization.
• Approach used: Abdominal or vaginal.
• Technique: Pomeroy, Parkland, fimbriectomy, etc.
• Details of procedure: Laterality, incision, hemostasis, complications.
• Confirmation of tube transection or occlusion.
• Pathology or specimen report (if applicable).

Detailed documentation strengthens payer approval, supports compliance, and prevents denials.

Example Scenarios

Scenario 1 – Elective Mini-Laparotomy Sterilization

A 34-year-old woman requests permanent sterilization. Surgeon performs a bilateral tubal ligation through a mini-laparotomy using the Pomeroy method.

→ Report CPT 58600.

Scenario 2 – Postpartum Sterilization After Cesarean Section

During a C-section, the physician performs bilateral tubal ligation at the patient’s request for permanent sterilization.

→ Report CPT 58600 with modifier 59, indicating a distinct procedure from the delivery.

Scenario 3 – Unilateral Tubal Ligation Due to Prior Surgery

A patient has only one fallopian tube due to prior surgery. The surgeon performs ligation of the remaining tube through an abdominal incision.

→ Report CPT 58600 with modifier 52 (reduced service).

Each scenario highlights how documentation and clinical details determine correct coding and modifier usage.

Why Choose BillingFreedom for OBGYN Billing

Sterilization procedures like CPT 58600 require precise documentation, correct modifier use, and compliance with payer consent rules. Errors in these areas often result in denials or delayed payments.

At BillingFreedom, our expert coders specialize in OBGYN medical billing services, ensuring accurate claim submission, compliance with CMS sterilization policies, and faster reimbursements.

We help OBGYN practices by:

• Managing payer-specific consent requirements.
• Applying accurate CPT and modifier codes.
• Preventing claim denials and ensuring clean submissions.
• Staying current with AAPC and CMS billing updates.

For more details about our exceptional OBGYN medical billing services, please don't hesitate to contact us via email at info@billingfreedom.com or call us at +1 (855) 415-3472. 

Your financial tranquility is our priority!