CPT Code 58605 Complete Guide to Postpartum Tubal Ligation (Abdominal or Vaginal Approach)

CPT 58605 is used to report a postpartum sterilization procedure performed after a vaginal delivery, during the same hospital admission.

This procedure permanently prevents pregnancy by surgically ligating or transecting one or both fallopian tubes through either an abdominal or vaginal approach. It is commonly performed shortly after childbirth once the patient is medically stable.

CPT Code 58605 – Description

The official definition of CPT code 58605 is:

“Ligation or transection of fallopian tube(s), abdominal or vaginal approach, postpartum, unilateral or bilateral, during the same hospitalization (separate procedure).”

This code covers postpartum tubal sterilization, performed after a vaginal delivery during the same hospitalization. The procedure may be abdominal (commonly mini-laparotomy) or vaginal, and can involve one or both fallopian tubes. The designation “separate procedure” indicates it may be billed independently if not bundled with another major surgery.

This code is not used for:

• Sterilization during cesarean delivery (use add-on code +58611)
• Interval (non-postpartum) tubal ligation (58600)
• Laparoscopic tubal sterilization (58670 or 58671)

Scenarios Where CPT Code 58605 Is Applicable

You would bill CPT code 58605 in the following situations:

Postpartum Sterilization After Vaginal Delivery:

When a patient requests permanent sterilization following a vaginal birth, and the procedure occurs before hospital discharge.

Example:

A 32-year-old patient undergoes bilateral tubal ligation via a mini-laparotomy on postpartum day 1 after an uncomplicated vaginal delivery. Operative notes document the postpartum status, surgical approach, and successful transection/ligation of both fallopian tubes.

Unilateral Tubal Ligation:

If only one fallopian tube is ligated due to prior surgery or anatomic considerations, the same code (58605) is used. Documentation must specify which tube was treated and why unilateral ligation was performed.

Applicable Modifiers for CPT Code 58605

Modifier 22 – Increased Procedural Services

Use if the procedure required additional effort due to anatomical challenges, adhesions, or other technical difficulties. Documentation must justify the increased service.

Other routine modifiers are generally not required for this code unless payer-specific rules indicate otherwise.

CPT Code 58605 – Billing & Reimbursement

To ensure proper reimbursement for CPT code 58605, follow these key steps:

Justify Medical Necessity:

Document postpartum status, patient consent for sterilization, and clinical rationale for tubal ligation.

Use Accurate ICD-10 Codes:

Pair CPT 58605 with appropriate postpartum or sterilization diagnosis codes, such as:

• Z30.2 – Encounter for sterilization
• O90.x – Postpartum complications, if relevant

Confirm Procedural Details:

The operative report should clearly document:

• Postpartum status (vaginal delivery completed)
• Surgical approach (abdominal or vaginal)
• Unilateral or bilateral tubal ligation
• Any intraoperative complications or technical challenges

Detailed Documentation:

Include all operative steps, patient consent, and postoperative monitoring to support coding and reimbursement.

Reimbursement Considerations:

CPT 58605 is a standalone code for postpartum tubal ligation. Proper documentation ensures payers recognize the separate procedure, supports compliance, and helps avoid claim denials or underpayment.

BillingFreedom - Expert Support for OBGYN Billing And Coding With Revenue Integrity

OBGYN medical billing requires precise knowledge of global maternity rules, modifier usage, Medicaid sterilization compliance, and payer documentation standards. BillingFreedom’s specialist RCM team actively manages obstetric procedure coding, including CPT 58605, with updated payer guidance and rigorous QA review.

Our teams leverage structured workflows, denial analytics, and payer-rule intelligence to protect healthcare revenue. Clients working with BillingFreedom typically experience:

• 98%+ coding accuracy rates
• denial rates under 4–6%
• over 95% clean-claim submission success
• improved net collections and reduced A/R aging

Accurate billing for postpartum sterilization directly supports compliant reimbursement and prevents revenue leakage. BillingFreedom continuously monitors coding updates and payer trends so your practice stays aligned and is paid the first time.

For more details about our exceptional OB/GYN billing services in South Carolina, 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!