CPT Code 58750 Tubotubal Anastomosis (Tubal Reanastomosis)

Tubal ligation reversal, or tubotubal anastomosis, is a delicate procedure that reconnects previously ligated or severed fallopian tubes to restore fertility. 

CPT 58750 is used for open surgical repair of the fallopian tubes, often using microsurgical techniques to excise scarred portions and reanastomose the healthy proximal and distal segments. 

Accurate coding, detailed documentation, and correct modifier use are critical to ensure proper reimbursement and compliance with payer requirements.

CPT Code 58750 – Description

The official definition of CPT code 58750 is:

“Open surgical tubotubal anastomosis.”

Key points:

• Performed through an abdominal incision to access the fallopian tubes.
• Excises scarred or occluded segments of the tube.
• Reanastomosis of proximal (uterine) and distal (fimbrial/ovarian) ends using microsurgical suturing.
• Confirmation of tubal patency, often with intraoperative dye or saline testing.
• Distinct from tubouterine implantation (58752) and fimbrioplasty (58760).
• Typically elective, aimed at restoring fertility; coverage may vary depending on payer.

Scenarios Where CPT Code 58750 Is Applicable

Infertility Following Tubal Ligation:

Patients who previously underwent tubal sterilization may elect surgical reconnection to restore fertility.

Post-Surgical Tubal Obstruction:

Patients with tubal blockage from prior pelvic surgery or trauma can benefit from tubotubal anastomosis.

Examples:

• A 34-year-old patient who previously had bilateral tubal ligation undergoes open anastomosis of both fallopian tubes to restore fertility.
• A patient with distal tubal scarring after pelvic infection undergoes an open tubotubal anastomosis to re-establish tubal patency.

Applicable Modifiers for CPT Code 58750

Modifier -50 – Bilateral Procedure

Applied when both fallopian tubes are surgically reconnected during the same session.

Modifier 22 – Increased Procedural Services

Used if the procedure is unusually complex due to extensive adhesions or anatomical variations.

Modifier 59 – Distinct Procedural Service

Applicable if the anastomosis is performed independently of other major pelvic surgeries.

CPT Code 58750 – Billing & Reimbursement

To ensure proper reimbursement for CPT code 58750, follow these guidelines:

Justify Medical Necessity:

Document the indication for tubal reconnection, previous tubal surgery history, and expected fertility benefit.

Use Accurate ICD-10 Codes:

Examples include:

• N97.1 – Female infertility due to tubal obstruction
• N97.2 – Female infertility due to tubal ligation

Confirm Procedural Details:

• Abdominal incision and access
• Excision of scarred segments
• Microsurgical reanastomosis
• Confirmation of patency
• Bilateral vs. unilateral details

Reimbursement Considerations:

Accurate coding ensures payers recognize the technical complexity, differentiates open anastomosis from related procedures, and supports reimbursement for fertility-restoring surgery.

BillingFreedom - Trusted OBGYN Medical Billing Services for Tubotubal Anastomosis

Complex procedures like CPT 58750 demand precise coding, documentation review, and understanding of payer requirements. BillingFreedom’s OBGYN medical billing services help practices:

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Our team stays up-to-date with AMA CPT updates, NCCI edits, and payer policies, ensuring that claims for tubotubal anastomosis accurately reflect procedural complexity. By partnering with BillingFreedom for OBGYN medical billing services, practices maximize revenue, reduce administrative burden, and maintain compliance while focusing on patient care.

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