CPT Code 58660: Laparoscopy, With Lysis of Adhesions

Learn about CPT code 58660, laparoscopic lysis of adhesions on fallopian tubes or ovaries, for enhance billing process.

What is CPT code 58660?

CPT code 58660 refers to laparoscopic surgical removal or destruction of pelvic adhesions, also known as adhesiolysis. Pelvic adhesions may result from prior surgeries, infections (e.g., PID), or endometriosis, causing pain, infertility, or bowel dysfunction. This laparoscopy surgical code targets scar tissue that may affect the normal movement of reproductive organs such as the fallopian tubes and ovaries.

The procedure involves inserting a laparoscope through small abdominal incisions and using electrosurgical or laser tools to separate fibrous tissue binding pelvic organs such as the uterus, ovaries, or bowel. This minimally invasive laparoscopic procedure can reduce post-surgical pain and improve fertility outcomes. When adhesions involve intestinal adhesion or pelvic structures, the lysis of adhesions may be extensive and medically necessary as a separate procedure.

CPT code 58660 documentation requirements

The documentation requirements for CPT Code 58660 emphasize clear, detailed operative notes that demonstrate the procedure was distinct, extensive, and required significant additional effort beyond the primary surgery. Key points include:

Documentation must specify that the adhesions were dense, extensive, and/or fibrous, causing distortion of normal anatomy and requiring substantial time and effort to remove. This supports medical necessity for reporting the 58660 CPT code.
The lysis of adhesions must be a separate, medically necessary procedure, not an integral or routine part of the primary laparoscopic surgery. The use of a modifier may be required to support reimbursement.
The surgeon should document the increased time spent and complexity of the adhesiolysis compared to a typical procedure without adhesions. The provider should follow current procedural terminology guidelines closely.
The operative note should include the indication for adhesiolysis, the anatomic location (e.g., fallopian tubes or ovaries), the process of lysis, and the outcome of the procedure. This information helps justify the code 58660 under payer policies.
Some payers may have specific rules about reporting this code separately, so it is advisable to verify with the payer for any additional documentation or coding requirements at the hospital or facility where the procedure was performed.

CPT code 58660 billing guidelines

The billing guidelines for CPT code 58660 include the following key points:

CPT 58660 can be reported in addition to the primary laparoscopic procedure only if dense or extensive adhesions are encountered that require effort beyond the usual laparoscopic surgery. Adhesiolysis is typically included in the primary procedure, so separate billing is justified only when the adhesiolysis is a distinct, significant service.
When reporting 58660 separately from a primary procedure, modifier -59 (distinct procedural service) is often required to indicate it is not part of the main procedure.
Clear operative notes must describe the extent, density, and complexity of the adhesions, the additional time and effort required, and how the adhesiolysis was distinct from the primary procedure.
Some third-party payers may have specific rules or may not allow separate payment for adhesiolysis with other laparoscopic procedures. It is recommended to check with individual payers for their policies before billing separately. The physician or coding specialist should review all applicable documentation before submitting the claim.

Other relevant CPT codes

58740 - Lysis of adhesions (salpingolysis, ovariolysis)
44180 - Laparoscopy, surgical, enterolysis (freeing of intestinal adhesions) (separate procedure)
44005 - Enterolysis (freeing of intestinal adhesions) (separate procedure)
53500 - Urethrolysis, transvaginal, secondary, open (for urethral adhesions)
58662 - Laparoscopy, surgical; with fulguration or excision of lesions of ovary, pelvic viscera, or adhesions

Frequently asked questions

No. Only report if it was a distinct, medically necessary therapeutic intervention as a separate procedure affecting fallopian tubes, ovaries, or nearby structures.

Yes, with appropriate modifier and supporting documentation that adheres to current procedural terminology and payer-specific guidelines.

No. Use 49320 for diagnostic laparoscopy without treatment. Code 58660 is used when surgical lysis is performed on adhesions involving reproductive organs.