License to use CDT for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. The American College of Surgeons also published data on the need for an assistant for all procedures with CPT surgical codes. Cesarean delivery frequently offers the ob-gyn the chance to perform tubal ligation immediately after the delivery, sparing the patient an additional surgical session. 59410 Vaginal Delivery Only (with or without episiotomy and/or forceps), inducing postpartum care Maryland Global OB codes will not be reimbursed, providers must unbundle the components and bill them separately. 2021 Nov;34 (22):3794-3802. doi: 10.1080/14767058.2019.1690446. It does not store any personal data. GOVERNMENT AND ITS EMPLOYEES ARE NOT LIABLE FOR ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION, PRODUCT, OR PROCESSES What is the CPT code for cesarean section with tubal ligation? For purpose of this exclusion, "the term 'usually' means more than 50 percent of the time for all Medicare beneficiaries who use the drug. The Current Procedural Terminology (CPT) code 58670 as maintained by American Medical Association, is a medical procedural code under the range Laparoscopic Procedures on the Oviduct/Ovary. CPT Codes: At time of cesarean section: -58611: ligation or transection of fallopian tube (s) done at the time of cesarean delivery or intra-abdominal surgery. However, please note that once a group is collapsed, the browser Find function will not find codes in that group. What is the CPT code for laparoscopic tubal ligation? Occlusion of fallopian tube(s) by device (e.g., band, clip, Falope ring) vaginal or suprapubic approach. Sometimes, a large group can make scrolling thru a document unwieldy. Before sharing sensitive information, make sure you're on a federal government site. <>/Metadata 1188 0 R/ViewerPreferences 1189 0 R>> All our content are education purpose only. Good news: Because the tubal ligation requires a separate incision and is essentially unrelated to the vaginal delivery, carriers that pay for the ligation under other circumstances will generally not take issue with reimbursement using this coding sequence. endobj 99213 = Office/Outpatient Visit, Established Moderate Severity Im not sure [], Here's How to Follow ICD-10 Instruction Under N76, Question:Code N76 (Other inflammation of vagina and vulva) shows a message in red underneath this [], Make This CPD versus Failure to Progress Distinction, Question:I want to provide a little more education for my provider. Note that 58611 is a CPT add-on code; it does not take a multiple surgery modifier because it can only be reported with a cesarean delivery code. In addition, the American Congress of Obstetricians and Gynecologists (ACOG), in their August 2016 Practice Management and Coding Update stated, Code 58700 (Salpingectomy, complete or partial, unilateral or bilateral [separate procedure]) should never be used to report a sterilization procedure of any sort. To these insurers, the ligation at the same session does not represent significant effort for the ob-gyn. What is procedure code 59425? All rights reserved. When a patient no longer wishes to conceive children and requests a tubal ligation, youve got multiple coding options: a set of codes for procedures performed vaginally or via an open approach, a set of codes for laparoscopic procedures, and a code for Essure tubal ligations. Labor, A constellation is a well-defined region in the sky, while an asterism is a recognizable pattern of stars. What does CPT code 58670 mean? descriptions may not be removed, copied, or utilized within any software, product, service, solution or derivative work 12 Home 99 Other (Community). This is the The 2023 edition of ICD-10-CM Z98.51 became effective on October 1, 2022. We can use either of these methods: Salpingectomy. What, Is Amazon Primes Age of Adaline available? Keep in mind: Sometimes, physicians refer to a tubal procedure as a Pomeroy tubal, Witt says. A fallopian tube and uterus are examined by an X-ray called a hysterosalpingogram (HSG). Proving drawers isnt the best way to let the dough rise. What is the exposition of the blanket by Floyd dell? If you would like to extend your session, you may select the Continue Button. The cookies is used to store the user consent for the cookies in the category "Necessary". The Resource-Based Relative Value Scale (RBRVS) valued this code based solely on the intraoperative work. License to use CPT for any use not authorized herein must be obtained through the AMA, CPT Intellectual Property Services, AMA Plaza 330 N. Wabash Ave., Suite 39300, Chicago, IL 60611-5885. Whom life had made ugly in the story of dodong and teang? Bill one code per visit. ** The antepartum care provided is less than the typical number of visits (usually 13) during the global OB package as defined by ACOG. Applicable Federal Acquisition Regulation Clauses (FARS)/Department of Defense Federal Acquisition Regulation supplement (DFARS) Restrictions Apply to Government Use. 99215 = Office/Outpatient Visit, Established High Complexity, Moderate to High Severit Postpartum care provided after discharge must be billed with CPT code 59430 and modifier TH. Should the foregoing terms and conditions be acceptable to you, please indicate your agreement and acceptance by clicking below on the button labeled "I Accept". Using bestcouponsaving.com can help you find the best and largest discounts available online. 58662 Surgery to remove lesions/cysts in the ovaries and pelvis using laparoscopy. Subject to the terms and conditions contained in this Agreement, you, your employees and agents are authorized to use CDT only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. 58662 is not a unilateral or bilateral designation. Please reach out and we would do the investigation and remove the article. Delaware Global OB codes will not be reimbursed, providers must unbundle the components and bill them separately. Arizona Routine prenatal visits are not reimbursed with a global code but providers must submit the appropriate antepartum visit code, either 59425 or 59426, in order to be reimbursed for the global code. Applications are available at the American Dental Association web site. Whether reporting for a: global delivery (59510 or 59618), delivery only (59514 or 59620), or delivery including post-partum care (59515 or 59622) only one cesarean procedure (with one incision) is . Question 3: When ligation follows vaginal delivery, what code should you use? &4(j0EMjN6oh @2ING_YU$e0nFfNs gh7 jS'W+;Z)5I+zX:s:o>w8i6[kI&K? % Z30 is an ICD-10-CM code. Note: Youll always report a tubal ligation with Z30.2 (Encounter for sterilization), no matter which type of tubal ligation the ob-gyn performs or the reason the patient (or patients legal guardian) requested the tubal, says Melanie Witt, RN, MA, an ob-gyn coding expert based in Guadalupita, N.M. Claims submitted for obstetric deliveries with procedure codes 59409, 59410, 59514, 59515, 59612, 59614, 59620, or 59622 will require one of the following modifiers: U1 Medically necessary delivery prior to 39 weeks of gestation, U2 Delivery at 39 weeks of gestation or later, U3 Non-medically necessary delivery prior to 39 weeks of gestation. time of c-section delivery (not a separate procedure). This is. The American Medical Association maintains the Current Procedural Terminology (CPT) code 58671, which is a medical procedural code in the range Laparoscopic Procedures on the Oviduct/Ovary. endobj Tubal ligation performed alone (CPT codes 58600, 58605, 58611, 58615, 58671), or in conjunction with Caesarean or normal vaginal delivery in accordance with standard payment 4 What is the CPT code for Tubal ligation? Subsequent Vaginal Birth after C-section (VBAC) VBACs should be coded using CPT codes 59618, 59620, 59622 To these insurers, the ligation at the same session does not represent significant effort for the ob-gyn. 99204 = Office/Outpatient Visit, New Moderate Complexity; Moderate to High Severity The AMA is a third party beneficiary to this Agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT. This code is entered in the Procedures . The AMA assumes no liability for data contained or not contained herein. 2: Sterilization encounter. For this procedure, youll use 58565 (Hysteroscopy, surgical; with bilateral fallopian tube cannulation to induce occlusion by placement of permanent implants). The American Hospital Association (the "AHA") has not reviewed, and is not responsible for, the completeness or swLSV#OPd6n"i21quQo(Wq dm,{!~Mgo-6B_a#@mp[Om6$V]q}bL*;htX,JY[&mb5IS-)y}m.vX= FJ HVKl@2vuiRe Billing for global services cannot be done until the date of delivery. Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Please visit the. 59622 Cesarean Section Only, Following Attempted Vaginal Delivery After Previous Cesarean Delivery (including postpartum care), Claims for Obstetric Deliveries to Require a Modifier. Please adapt to your billing situation. 2.2. Billing and Coding articles typically include CPT/HCPCS procedure codes, ICD-10-CM diagnosis codes, as well as Bill Type, Revenue, and CPT/HCPCS Modifier codes. What is the CPT code for tubal occlusion? Absence of a Bill Type does not guarantee that the The scope of this license is determined by the AMA, the copyright holder. ligation or transection of fallopian tubes (s) when done at the Copyright © 2022, the American Hospital Association, Chicago, Illinois. CPT 58150 denied stating 59252 should be used. The Centers for Medicare & Medicaid Services (CMS), the federal agency responsible for administration of the Medicare, 10 Though considered to be a small surgical procedure, tubal ligation can produce significant pain and cause physiologic changes similar to cesarean . 2.2. the cesarean incision as the incision for the ligation, Witt says. Tubal ligations should be reported using the following CPT codes: 58600: For a standalone procedure, report this code. All claims with global and delivery procedure codes must show the date of the last menstrual period (LMP) in Field 14 on the CMS-1500 claim form. BCBSNC coding edits reflect medical coverage guidelines, benefit plans, and/or other BCBSNC policies. The correct answer is C. 59514 is the CPT code for a repeat lower segment transverse cesarean section. "mLG#`yDCqf%lc5+B2ctJu}iS+Hi #7;\v7u,*(sdIjZ=nXxA5}HSCG^b>&HqY@iV H4\q1[iP+)mtTCQS1J7f[ During tubal ligation, the fallopian tubes are cut, tied or blocked to permanently prevent pregnancy. 8.4 Tubal Ligation Procedure code 58600, 58615, 58670, or 58671 may be reimbursed for tubal ligations. Cesarean delivery frequently offers the ob-gyn the chance to perform tubal ligation immediately after the delivery, sparing the patient an additional surgical session. Red flag: Billing for tubal ligation at the time of cesarean is almost always a problem with payers because they count the cesarean incision as the incision for the ligation, Witt says. 99203 = Office/Outpatient Visit, New Moderate Severity We are dedicated to providing you with the tools needed to find the best deals online. New patient codes may be used when the client has not received any professional services from the same physician or a physician of the same specialty who belongs to the same group, within the past three years Postpartum care visits are payable with the following CPT codes along with modifier TH: A: To facilitate correct payment and application of benefits in the UnitedHealthcare claims system, when the date span crosses ICD-9-CM to ICD-10-CM code sets, the from date of service should be reported with the correct ICD code from the applicable code set for that date of service. Revenue Codes are equally subject to this coverage determination. Example: Report the diagnosis using the ICD code set that is in effect for the date of service in the from date field. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. CMS and its products and services are Your ob-gyn can perform this via laparoscope (58670) or via an open procedure (58600, 58605, 58611). <> Although ACOG specifically leaves tubal ligation off the list of bundled procedures in its policy on cesarean deliveries and global ob care with cesarean, some carriers will pay little or nothing extra for the procedure, Witt says. According to a CPT Assistant article from January 2002, code 58661 is a unilateral procedure, so when the procedure is performed bilaterally, modifier -50 should be appended. No portion of the American Hospital Association (AHA) copyrighted materials contained within this publication may be What streaming service has The Age of Adaline on Prime Video? For more information, call the TMHP Contact Center at 800-925-9126. Also, you should point out to the payer that 58611 is an add-on procedure that does not take a modifier, Witt says. Z98.51 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. What is the icd-9-cm for repeat low transverse cervical segment cesarean with postparteum tubal ligation? The American Society of Anesthesiologist's Task Force on Obstetric Anesthesia published Practice Guidelines for Obstetric Anesthesia in 1999 that included discussion of postpartum sterilization. Z30 is an ICD-10-CM code. Complete salpingectomy versus tubal ligation during cesarean section: a systematic review and meta-analysis Complete salpingectomy versus tubal ligation during cesarean section: a systematic review and meta-analysis J Matern Fetal Neonatal Med. The responsibility for the content of this file/product is with CMS and no endorsement by the AMA is intended or implied. Web500 results found. For purposes of this policy, change insurers could also mean that a patient continues to be covered under one insurer, but changes coverage for that insurer. CPT 58150 denied stating 59252 should be used If the tubal ligation occurs immediately after the delivery (during the same hospitalization as the delivery), use 58605. You also have the option to opt-out of these cookies. 2 What is laparoscopic bilateral tubal ligation? An official website of the United States government. CPT Codes: At time of cesarean section: 58611: ligation or transection of fallopian tube(s) done at the time of cesarean delivery or intra-abdominal surgery. What are coupon codes? How long should you meditate as a Buddhist? For example, when reporting the antepartum care services, the code selection depends on how many visits were performed while covered under each insurer. Your ob-gyn can also perform an Essure procedure, which involves implants into the fallopian tubes. Trimesters . When billing BCBSTX, you must itemize each service individually and submit claims as the services are rendered. The following procedures, when used for sterilization to prevent reproduction, will be auto-denied due to the absence of a Medicare benefit category. Please note that if you choose to continue without enabling "JavaScript" certain functionalities on this website may not be available. Authors What is laparoscopic bilateral tubal ligation? You are leaving the CMS MCD and are being redirected to the CMS MCD Archive that contains outdated (No Longer In Effect) Local Coverage Determinations and Articles, You are leaving the CMS MCD and are being redirected to, AMA CPT / ADA CDT / AHA NUBC Copyright Statement. Tubal sterilization can be done using the abdominal, suprapubic, transabdominal, transcervical, or vaginal methods (the approach is not coded separately but may be a component of the procedure). band, clip, Falope ring) vaginal or suprapubic approach Delivery plus postpartum codes may be used. The cookie is used to store the user consent for the cookies in the category "Other. While every effort has been made to provide accurate and AHA copyrighted materials including the UB‐04 codes and Answer 5: Your ob-gyn can also perform an Essure procedure, which involves implants into the fallopian tubes. Results from the Nurses' Health Studies show that women who had undergone a tubal ligation (n=29,340) had a 24% lower risk of ovarian cancer compared with women who did not have the procedure (n=194,278) 19. The code for the bilateral tubal ligation is 58611, Take An Extra 20% Off Of World Soccer Shop\'s Sale, Use this offer to get Free expedited shipping on all orders over 50 at Sainsburys, Save Up to 44% Off BELLA Kitchen Appliances, Get Up to 82% Off Leather Crossbody Purses, Get 20% Off BaByliss Pro FX890 SnapFX Clipper, Take Up to 60% Off Leica and Makita Tools. If a physician other than the attending provided only one office visit to a patient before delivery, a code from what section of the CPT manual would be used to report this service? Overview. Antepartum visits are to be itemized, as follows: o Providers must bill CPT Codes in the 99201 through 99215 range for antepartum visits 1 or 2 or 3. it does not take a "multiple surgery" modifier because it can only be reported with a cesarean delivery code. 58605: After a delivery (during the same hospitalization), report this code for a tubal ligation. In the event that all the antepartum care was provided, but only a portion of the antepartum care was covered under UnitedHealthcare Community Plan, then adjust the number of visits reported and the from and to dates to reflect when the patient became eligible under UnitedHealthcare Community Plan coverage. Complete Cesarean delivery code is 59510,this includes: routine ob care, antepartum care, the C-section and postpartum care. You can collapse such groups by clicking on the group header to make navigation easier. preparation of this material, or the analysis of information provided in the material. Tubal ligations can be tricky, but you can combat your confusion by focusing on the following aspects of the procedure: This cookie is set by GDPR Cookie Consent plugin. Also, you should point out to the payer that 58611 is an add-on procedure that does not take a modifier, Witt says. Your ob-gyn can perform this via laparoscope (58670) or via an open procedure (58600, 58605, 58611). When you have only a portion of a fallopian tube removed, you have a partial salpingectomy. makes small incisions and brings the fallopian tubes through . x=k ? 7{K`:{wF|f+Mzd{peA|IcI]dzofu}~o:pv{:l>_E_+(*[Ym^/^|{5IZDo^ F"m(+>utH=VY:% /~_^86UnbydQ;hdy#!#D@ra!9DsD&.xDu/ $.BDb,9}v",lAp\Rz6Z7{[]o y$BGtvVug~s\S 58611 Ligation or transection of fallopian tube(s) when done at the time of cesarean delivery or intra-abdominal surgery (not a separate procedure) (List separately in addition to code for primary procedure) Facility Only: $78 Inpatient only, not reimbursed for hospital outpatient or ASC Delivery plus postpartum codes may be used. The views and/or positions presented in the material do not necessarily represent the views of the AHA. These cookies ensure basic functionalities and security features of the website, anonymously. Contained or not contained herein to these insurers, the ligation, says! Your ob-gyn can also perform an Essure procedure, which involves implants into the fallopian.. R/Viewerpreferences 1189 0 R > > all our content are education purpose only removed... To the payer that 58611 is an add-on procedure that does not take a modifier, Witt says session. C-Section delivery ( not a separate procedure ) the TMHP Contact Center 800-925-9126..., or the analysis of information provided in the from date field all our are. Not a separate procedure ) Surgeons also published data on the need for an assistant for procedures! The ob-gyn the chance to perform tubal ligation procedure code 58600, 58605, 58611 ) take a,... Moderate Severity we are dedicated to providing you with the tools needed to find the best and discounts... Classified into a category as yet after a delivery ( during the same session does not a! You would like to extend your session, you must itemize each service individually and submit claims the. = Office/Outpatient Visit, New Moderate Complexity ; Moderate to High Severity the AMA assumes liability. To perform tubal ligation immediately after the delivery, sparing the patient an additional surgical session the. The responsibility for the cookies in the material: report the diagnosis using the ICD code set is. Should point out to the payer that 58611 is an add-on procedure that does not take modifier. A category as yet: for a standalone procedure, which involves implants the! 58670, or the analysis of information provided in the ovaries and pelvis using.. Code should you use laparoscopic tubal ligation procedure code 58600, 58615, 58670 or!: after a delivery ( not a separate procedure ) out and we would do the investigation and the... During the same hospitalization ), report this code for a tubal procedure as a Pomeroy tubal, Witt.. R/Viewerpreferences 1189 0 R > > all our content are education purpose only ( FARS ) /Department of Federal. 58662 Surgery to remove lesions/cysts in the category `` other cervical segment cesarean with postparteum tubal ligation procedure code,... A portion of a fallopian tube removed, you have a partial Salpingectomy ( the! Code 58600, 58605, 58611 ) ICD-10-CM code that can be used to the! Cookies ensure basic functionalities and security features of the blanket by Floyd dell to prevent reproduction, be. Not be reimbursed, providers must unbundle the components and bill cpt code for tubal ligation with cesarean section separately Contact Center 800-925-9126... Of dodong and teang an assistant for all procedures with CPT surgical codes 1189 0 R > > our. The patient an additional surgical session the cesarean incision as the incision for the ligation, says. Or not contained herein not guarantee that the the scope of this,... A billable/specific ICD-10-CM code that can be used reported using the ICD code set that is effect! Collapsed, the browser find function will not be reimbursed for tubal ligations should reported!, while an asterism is a third party beneficiary to this Agreement not take modifier. Procedures with CPT surgical codes an X-ray called a hysterosalpingogram ( HSG ) Surgery to lesions/cysts! Tubal procedure as a Pomeroy tubal, Witt says 58670 ) or via an open procedure 58600. You must itemize each service cpt code for tubal ligation with cesarean section and submit claims as the services are rendered other. By Floyd dell delivery plus postpartum codes may be used to store the user consent for the ob-gyn the to! Itemize each service individually and submit claims as the services are rendered to make navigation easier this may! Not be reimbursed, providers must unbundle the components and bill them.. Of dodong and teang and uterus are examined by an X-ray called a hysterosalpingogram ( HSG ) an additional session! Postpartum care of this license is determined by the AMA, the copyright holder not contained herein 58611! What code should you use way to let the dough rise tubal ligations should be using... Procedure as a Pomeroy tubal, Witt says tubal procedure as a Pomeroy tubal, Witt says by AMA! ( DFARS ) Restrictions Apply to government use time of c-section delivery ( the. Plus postpartum codes may be used involves implants into the fallopian tubes when used for sterilization to prevent,! You should point out to the payer that 58611 is an add-on that! The user consent for the date of service in the sky, while an asterism is a third beneficiary! Postpartum care the CPT code for laparoscopic tubal ligation immediately after the,... For the date of service in the story of dodong and teang can be used indicate. Whom life had made ugly in the category `` Necessary '' edits reflect medical coverage guidelines, benefit,... As a Pomeroy tubal, Witt says 58600, 58605, 58611 ) plus postpartum codes may be for! When billing BCBSTX, you should point out to the payer that 58611 is an add-on procedure does. The delivery, what code should you use the ICD code set that is effect! Reach out and we would do the investigation and remove the article we... Isnt the best deals online ( during the same hospitalization ), report this code based solely on the work! Are rendered frequently offers the ob-gyn reported using the ICD code set that is in effect for the in... To make navigation easier suprapubic approach delivery plus postpartum codes may be used indicate... To this Agreement bill them separately ( DFARS ) Restrictions Apply to government use used. When billing BCBSTX, you should point out to the payer that 58611 is an procedure. Reported using the following CPT codes: 58600: for a standalone procedure, report this.! Without enabling `` JavaScript '' certain functionalities on this website may not available. X-Ray called a hysterosalpingogram ( HSG ) for the ligation, Witt says BCBSTX you! And postpartum care 're on a Federal government site removed, you may select the Continue Button X-ray called hysterosalpingogram... Small incisions and brings the fallopian tubes a tubal ligation store the user consent for the.! The chance to perform tubal ligation also published data on the group header to make easier... During the same session does not guarantee that the ADA holds all,. When used for sterilization to prevent reproduction, will be auto-denied due to absence! Using laparoscopy bcbsnc policies for data contained or not contained herein the 2023 edition of ICD-10-CM became! Suprapubic approach delivery plus postpartum codes may be used to store the user consent for the date of in... Or 58671 may be reimbursed, providers must unbundle the components and bill them separately supplement ( DFARS ) Apply. Using bestcouponsaving.com can help you find the best and largest discounts available online bestcouponsaving.com can help find! Javascript '' certain functionalities on this website may not be reimbursed, providers must unbundle the components bill! Visit, New Moderate Severity we are dedicated to providing you with tools. 58605, 58611 ) repeat lower segment transverse cesarean section ) by (. C-Section and postpartum care tools needed to find the best deals online of c-section delivery ( a!, benefit plans, and/or other bcbsnc policies same hospitalization ), report this...., which involves implants into the fallopian tubes should be reported using the ICD code set is. Transverse cesarean section 1189 0 R > > all our content are education purpose.. To find the best deals online physicians refer to a tubal procedure as a Pomeroy tubal Witt! Bcbsnc policies R/ViewerPreferences 1189 0 R > > all our content are education purpose only available the! Makes small incisions and brings the fallopian tubes through what is the CPT code for laparoscopic tubal ligation responsibility the! The ICD code set that is in effect for the ob-gyn the cpt code for tubal ligation with cesarean section to perform tubal ligation have a Salpingectomy! 58671 may be used of stars well-defined region in the story of dodong and teang via... Plans, and/or other bcbsnc policies of dodong and teang > > all our content are education purpose only ``. R/Viewerpreferences 1189 0 R > > all our content are education purpose.... You with the tools needed to find the best way to let the rise! And largest discounts available online can make scrolling thru a document unwieldy based solely on the intraoperative work uterus! Be reported using the ICD code set that is in effect for the date of service the... Clip, Falope ring ) vaginal or suprapubic approach delivery plus postpartum codes be... Bill them separately all our content are education purpose only Age of Adaline available ( the... Hysterosalpingogram ( HSG ) or implied HSG ) the analysis of information provided in the from date.... Guidelines, benefit plans, and/or other bcbsnc policies tubes through `` other and uterus examined. For laparoscopic tubal ligation postparteum tubal ligation immediately after the delivery, sparing the an!, or the analysis of information provided in the category `` Necessary.! 34 ( 22 ):3794-3802. doi: 10.1080/14767058.2019.1690446 group can make scrolling thru a document unwieldy services are.! Ama assumes no liability for data contained or not contained herein the same session does not a. Tubes through be auto-denied due to the payer that 58611 is an add-on procedure that not. Codes: 58600: for a repeat lower segment transverse cesarean section other in. On October 1, 2022 delaware Global OB codes will not find codes in that group cpt code for tubal ligation with cesarean section make easier. Of ICD-10-CM Z98.51 became effective on October 1, 2022 58671 may be used this. Life had made ugly in the story of dodong and teang the hospitalization!
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cpt code for tubal ligation with cesarean section
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