Bringing opportunistic salpingectomy to your site

What quality leaders and surgeon champions need to plan for: the privileging pathway, what MI-MAGIC supplies, and what your site arranges locally.

Assess your readiness Read the clinician implementation guide

Requiring a gynecology consult for every candidate does not scale: 44% of US counties have no practicing OB-GYN. The Michigan model trains general surgeons to counsel eligible patients directly, supported by an identified gynecologic champion at each site and by the Michigan Surgical Quality Collaborative (MSQC).

Phase 1 in Michigan focuses on appendectomy and non-cancer colorectal surgery in women age 50 and older. A site adopting the program should expect surgeon training, a privileging request, and a gynecologic champion to be in place before the first case, not built afterward.

Medicaid timing constraint. Federal sterilization rules (Title XIX) require a signed sterilization consent at least 30 days before surgery for Medicaid beneficiaries. Sites that raise the option at the first surgical visit avoid this timing closing the door on an informed choice.

What MI-MAGIC supplies, what your site supplies

Reorganized from the clinician implementation guide - nothing here is new.

MI-MAGIC supplies

The protected video training curriculum, a knowledge check, and a versioned attestation for each surgeon
A downloadable training completion record for your privileging process
A drafted FPPE template for laparoscopic opportunistic salpingectomy that your medical staff office can adapt
Statewide measurement through the MSQC registry, linked with claims data
Manual review of every provider application

Your site supplies

The delineation-of-privileges request through your medical staff office
Proctoring for a surgeon’s first cases with an experienced salpingectomy surgeon
The FPPE chart review itself, using the MI-MAGIC template
An identified gynecologic champion surgeons can involve for counseling conversations

The privileging pathway

The pathway MI-MAGIC recommends to Michigan hospitals.

Request the specific privilege (laparoscopy plus salpingectomy) through your institution’s delineation-of-privileges process.
Complete the MI-MAGIC training curriculum, then proctoring with an experienced salpingectomy surgeon. See the clinician implementation guide for the current proctoring guidance.
FPPE: 100% chart review of the surgeon’s first five local cases within 12 months, against defined criteria - appropriate selection and consent, technique, specimen handling, and outcomes.

Request the drafted FPPE template at michigan-magic@umich.edu.

Billing follows CPT 58661 with modifier 50 and ICD-10 Z40.82 for the add-on procedure. The full coding table and the current Michigan Medicaid coverage note are on the clinician implementation guide.

Coming soon

Hospital readiness survey. A short survey for quality leaders assessing readiness at their site is being finalized for the October 2 meeting. This is a placeholder - the link will replace this block once it is available.

For the full patient-selection, counseling, surgical-conduct, and billing detail behind this pathway, see the clinician implementation guide. For the published evidence, see the evidence page.