Current Procedural Terminology (CPT) codes are standardized numerical identifiers used across the healthcare industry to describe medical services and procedures. These codes provide a uniform language for physicians, hospitals, and payers to communicate exactly what service was provided. Understanding the specific CPT code on a medical bill is necessary for patients seeking to understand their healthcare costs and insurance coverage. This article focuses on CPT code 58662, which describes a specific type of laparoscopic surgical removal within the female reproductive system.
The Specific Procedure CPT 58662 Covers
CPT code 58662 is defined as “Laparoscopy, surgical; with fulguration or excision of lesions of the ovary, pelvic viscera, or peritoneal surface by any method.” This minimally invasive procedure aims to remove or destroy abnormal growths in the lower abdomen and pelvis. Unlike code 58661, which covers the complete removal of adnexal structures like the ovary or fallopian tube, 58662 focuses on the removal or destruction of specific lesions. The targeted lesions are typically found on the ovary, the pelvic viscera (organs within the pelvic cavity), or the peritoneal surface (the membrane lining the abdominal cavity). The description includes both excision (cutting out tissue) and fulguration (destruction using electrical current). This procedure is commonly used for treatments such as ovarian cystectomy, which removes a cyst while preserving the rest of the ovary.
Medical Conditions Requiring This Procedure
The necessity for a procedure billed under CPT 58662 arises from various medical diagnoses involving abnormal growths or tissue within the pelvic cavity. One common indication is the management of ovarian cysts that are large, causing pain, or have features suspicious for malignancy. The goal is to remove the cyst itself while leaving the healthy ovarian tissue intact, a procedure known as an ovarian cystectomy.
Another frequent reason for this laparoscopic approach is the treatment of endometriosis, a condition where tissue similar to the uterine lining grows outside the uterus. These endometrial lesions can form on the ovaries, fallopian tubes, and the peritoneal surface, causing chronic pelvic pain. The surgeon uses the technique described by 58662 to excise or destroy these painful growths from the affected areas. The code may also be used when lesions, tumors, or growths are found on other pelvic organs or the peritoneum, requiring precise, minimally invasive removal.
The Laparoscopic Approach
The surgical approach described by CPT 58662 is laparoscopy, a technique that is fundamentally different from traditional open surgery, known as laparotomy. Laparoscopy is characterized by its minimally invasive nature, requiring only a few small incisions, typically less than a half-inch each, instead of a single large incision. A laparoscope, which is a thin tube equipped with a camera and light source, is inserted through one incision, allowing the surgeon to view the pelvic organs on a monitor.
Specialized, long surgical instruments are then inserted through the other small incisions to perform the excision or fulguration of the lesions. Because the procedure avoids a large abdominal incision, patients generally experience significantly less post-operative pain and blood loss.
The reduced trauma to the body often leads to a shorter hospital stay, with many patients going home the same day or within 24 hours of the procedure. Recovery is also quicker compared to open surgery, with patients often returning to light activity within a few days and resuming normal routines within two weeks.
Patients should expect some soreness at the incision sites and possible shoulder pain from the carbon dioxide gas used to inflate the abdomen during the surgery. The small incisions are typically closed with dissolvable stitches or surgical adhesive, resulting in minimal scarring.
Understanding Billing and Modifiers
When CPT code 58662 is submitted to an insurance payer, its reimbursement is determined by the procedure’s assigned Relative Value Units (RVUs), which reflect the technical skill and time required. The code is often subject to the “global period,” which for major surgeries is typically 90 days. This means the payment for the procedure includes all routine pre-operative and post-operative care within that window, covering follow-up visits and standard care related to the surgery.
However, various circumstances can require the use of modifiers, which are two-digit codes appended to 58662 to provide additional details to the payer. For example, if the surgeon has to deal with an unusual amount of scar tissue or the procedure takes significantly longer than expected, the modifier -22 (Increased Procedural Services) may be added to request greater reimbursement.
If the procedure is performed on both the left and right sides, such as removing a lesion from each ovary, the modifier -50 (Bilateral Procedure) would be used. Other common modifiers include -59 (Distinct Procedural Service), which is used when 58662 is performed on the same day as another procedure not normally bundled with it. When two surgeons are required, modifier -62 (Two Surgeons) indicates a co-surgery. The correct application of these modifiers is necessary to ensure accurate payment for the complexity of the service provided.