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CPT Code 58740 Open Lysis of Adhesions (Salpingolysis & Ovariolysis)

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Pelvic adhesions involving the fallopian tubes or ovaries can cause infertility, chronic pelvic pain, and complications from prior surgery, infection, or endometriosis. 

CPT 58740 is used for open surgical lysis of adhesions (salpingolysis and/or ovariolysis) via an abdominal incision. Accurate coding and documentation are essential for OBGYN practices to capture the complexity of the procedure, optimize reimbursement, and maintain compliance with payer requirements.

The official definition of CPT code 58740 is:

“Open surgical lysis of adhesions involving fallopian tube(s) (salpingolysis) and/or ovary(ies) (ovariolysis).”

Key points:

  • Performed through an abdominal incision (open approach).
  • Targets adhesions that interfere with fallopian tubes and/or ovaries.
  • Restores normal pelvic anatomy and organ function.
  • Preservation of reproductive organs is prioritized whenever possible.
  • Not for laparoscopic adhesiolysis (use 58660) or minor incidental adhesiolysis during other major procedures unless significant additional work is documented.

Scenarios Where CPT Code 58740 Is Applicable

You would bill CPT code 58740 in the following situations:

Infertility Due to Tubal or Ovarian Adhesions:

When a patient has scarring obstructing the fallopian tubes or ovaries and an open surgical approach is required to restore normal anatomy.

Chronic Pelvic Pain or Post-Surgical Complications:

Patients with persistent pelvic pain caused by adhesions from prior surgeries, infections, or endometriosis may require adhesiolysis.

Examples:

  • A 32-year-old patient with a history of pelvic infection undergoes open abdominal lysis of dense adhesions surrounding both fallopian tubes to improve fertility.
  • A patient with prior endometriosis surgery presents with recurrent pain and infertility; adhesions are surgically lysed via laparotomy.

Applicable Modifiers for CPT Code 58740

Modifier 22 – Increased Procedural Services

Use if the adhesiolysis is unusually complex due to dense or extensive adhesions, abnormal anatomy, or prior surgeries.

Modifier 59 – Distinct Procedural Service

Applicable if adhesiolysis is performed separately from other major pelvic procedures and documented as clinically distinct.

CPT Code 58740 – Billing & Reimbursement

To ensure proper reimbursement for CPT code 58740, follow these key steps:

Justify Medical Necessity:

Document the presence, location, and severity of adhesions, the clinical indication for open surgery, and the anticipated benefit (e.g., restoration of fertility, reduction of pain).

Use Accurate ICD-10 Codes:

Examples include:

  • N73.6 – Pelvic adhesions (female)
  • N97.0 – Female infertility due to tubal obstruction
  • N80.1 – Endometriosis of ovary

Confirm Procedural Details:

The operative note should clearly document:

  • Abdominal incision and access
  • Identification and division of adhesions
  • Preservation of fallopian tubes and/or ovaries
  • Hemostasis and closure
  • Any intraoperative complications or technical challenges

Reimbursement Considerations:

Accurate coding ensures payers recognize the complexity of open adhesiolysis, differentiates this procedure from laparoscopic or incidental adhesiolysis, and supports appropriate reimbursement while minimizing claim denials.

BillingFreedom - Advanced OBGYN Medical Billing Services for Complex Procedures

BillingFreedom’s team specializes in OBGYN medical billing services and understands the nuances of complex procedures, including open adhesiolysis. We review operative notes in detail, ensuring that all aspects of the surgery, adhesion location, extent, and complexity are adequately documented for coding accuracy.

Our team ensures that modifier application (e.g., 22 for increased complexity, 51 for multiple procedures) and billing strategies capture all eligible reimbursement. This precision directly increases practice revenue while avoiding compliance issues.

Comprehensive Support

Partnering with BillingFreedom for OBGYN medical billing services allows practices to focus on patient care while knowing their billing is accurate, compliant, and optimized for maximum reimbursement. Our approach ensures that complex procedures like CPT 58740 are captured correctly, claims are processed efficiently, and revenue opportunities are fully realized. With BillingFreedom, OBGYN practices gain a trusted partner that enhances financial performance while reducing administrative burden.

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

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