Wiki VAGINAL CUFF DEHISCENCE CPT CODE 57200???

[rockylopez]

Hello I wanted to seek any input from anyone that can help me. Patient had a hysterectomy with another provider (not in our medical group) 13 days ago. She came in the Ed with complaints of vaginal bleeding my doctor found that patient has a vaginal cuff dehiscense and requires to go to surgery for vaginal cuff closure. no injury or cause was documented. I am gearing towards cpt code 57200 and icd 10 code T81.31xa. Wanted to check with anyone and get their medical coding opinion thank you.

*PRE-PROCEDURE DIAGNOSIS:
Vaginal cuff dehiscence
*POST-PROCEDURE DIAGNOSIS:
Same

*PROCEDURE(S) PERFORMED:
Exam under anesthesia, vaginal cuff closure

*FINDINGS:
Dehiscence of the vaginal cuff, mostly on the right side. V-Loc suture released on the right apex. Still intact on the left side however, separation over the entire vaginal cuff was noted. Bleeding was coming from the vaginal epithelium anteriorly and posteriorly. Slight malodor noted upon entry into the vaginal cuff opening.

 

[Cmama12]

We use unlisted with 57200 as comparable. And agree with T81.31

 

[rockylopez]

We use unlisted with 57200 as comparable. And agree with T81.31

i noticed on the forum that i think unlisted code 59899 was used but our billing system doesnt have this unlisted code in place. Do you agree 57200 is supported?

 

[nielynco]

i noticed on the forum that i think unlisted code 59899 was used but our billing system doesnt have this unlisted code in place. Do you agree 57200 is supported?

You should update your billing system. We did an article on coding for vaginal cuff repair depending on the type and cause of the repair in the December, 2022 Ob/Gyn Coding Alert. I recommend comparing the work to the integumentary repair codes which is close to the work performed. 57200 is reported when there is an injury to the vaginal canal, not the vagina cuff.

 

[jamespr@sutterhealth.org]

Try CPT 13160 with modifier -78 if within the global period:
13160 (secondary closure of surgical wound or dehiscence, extensive or complicated), or. the unlisted code 58999.

 

[nielynco]

Try CPT 13160 with modifier -78 if within the global period:
13160 (secondary closure of surgical wound or dehiscence, extensive or complicated), or. the unlisted code 58999.

You would not report 13160 for this repair since the vaginal cuff is not part of the integumentary system. If this had been a repair of the external genitalia this might have worked, but not in this case in my opinion. You should also notice that this code carries an very high RVU value which would not be in keeping with a vaginal cuff repair which was not described as extensive or complicated.