CPT Code 58673 Laparoscopic Salpingostomy Coding & Billing Guide Laparoscopic Salpingostomy Coding & Billing Guide

Laparoscopic salpingostomy is a critical gynecologic procedure most commonly performed for the conservative management of tubal ectopic pregnancy. 

CPT 58673 is reported when the surgeon creates an opening in the fallopian tube to remove an ectopic pregnancy while attempting to preserve tubal function. Correct coding requires precise operative note details, appropriate use of modifiers, and compliance with payer policies.

CPT Code 58673 – Description

The official definition of CPT code 58673 is:

“Laparoscopy, surgical; with salpingostomy, incision of fallopian tube to remove ectopic pregnancy or obstruction, preserving tube.”

Key points:

• Minimally invasive laparoscopic procedure.
• Preserves the fallopian tube for future fertility.
• Not reported for removal of the tube (use 58661), reconstruction of fimbriae (58672), open surgery (58740), or sterilization procedures (58670/58671).

Scenarios Where CPT Code 58673 Is Applicable

You would bill CPT code 58673 in the following situations:

Treatment of Tubal Ectopic Pregnancy:

When a patient has a tubal ectopic pregnancy and the surgeon performs a conservative laparoscopic salpingostomy to remove the gestational tissue while keeping the tube intact.

Examples:

• A patient with a tubal ectopic pregnancy undergoes laparoscopic incision and removal of the pregnancy tissue, preserving the tube.
• Obstructive material within the distal fallopian tube is removed laparoscopically to restore tubal patency while preserving fertility.

Applicable Modifiers for CPT Code 58673

Modifier 22 – Increased Procedural Services

Use if the procedure is technically challenging due to adhesions, distorted anatomy, or previous surgeries.

No additional modifiers are generally required for standard laparoscopic salpingostomy.

CPT Code 58673 – Billing & Reimbursement

To ensure proper reimbursement for CPT code 58673, follow these key steps:

Justify Medical Necessity:

Document the presence of an ectopic pregnancy or tubal obstruction and the goal of fertility preservation.

Use Accurate ICD-10 Codes:

Examples include:

• O00.1 – Tubal pregnancy
• N97.0 – Female infertility associated with tubal origin

Confirm Procedural Details:

The operative note should clearly document:

• Laparoscopic approach
• Location and extent of tubal incision
• Removal of ectopic pregnancy or obstructive material
• Preservation of the fallopian tube
• Any intraoperative challenges or complications

Detailed Documentation:

Include preoperative findings, surgical rationale, intraoperative steps, and postoperative follow-up to support coding and modifier use.

Reimbursement Considerations:

Accurate coding ensures payers recognize the fertility-preserving nature of the procedure, differentiates it from salpingectomy, fimbrioplasty, open procedures, or sterilization, prevents claim denials, and supports appropriate reimbursement.

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