How To Use CPT Code 57160

CPT 57160 describes the fitting and insertion of a pessary or other intravaginal support device by a healthcare provider. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 57160?

CPT 57160 can be used to describe the fitting and insertion of a pessary or other intravaginal support device by a healthcare provider. This code is used when the provider assesses the patient’s condition, selects the appropriate type and size of pessary, and inserts it into the vagina to treat vaginal wall prolapse or other related disorders.

2. Official Description

The official description of CPT code 57160 is: ‘Fitting and insertion of pessary or other intravaginal support device.’

3. Procedure

1. The healthcare provider performs a vaginal exam to determine the proper type and size of pessary for the patient.
2. Multiple sizes may be tried until the correct fit is found.
3. The provider inserts the pessary into the vagina to provide support for the rectum or bladder, correct prolapse of the vaginal wall or uterus, help with stress urinary incontinence, or deliver medication.
4. Once the pessary is in place, the provider checks for possible incontinence and instructs the patient on how to insert, remove, and clean the pessary.
5. The patient is asked to walk with the pessary in place to ensure it remains correctly positioned.
6. The provider reexamines the vagina to ensure the pessary is still correctly in place.

4. Qualifying circumstances

CPT 57160 is performed for patients with vaginal wall prolapse or other related disorders that require the use of a pessary or intravaginal support device. The provider must assess the patient’s condition and determine the appropriate type and size of pessary. The procedure is typically performed by a healthcare provider with expertise in gynecology or urology.

5. When to use CPT code 57160

CPT code 57160 should be used when a healthcare provider fits and inserts a pessary or other intravaginal support device into the vagina to treat vaginal wall prolapse or related disorders. This code should be reported for each instance of fitting and insertion of a new pessary for the same patient.

6. Documentation requirements

To support a claim for CPT 57160, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for a pessary or intravaginal support device
• Type and size of pessary selected
• Date of the procedure
• Instructions provided to the patient on how to insert, remove, and clean the pessary
• Results of the examination after the pessary is inserted
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 57160, ensure that the procedure is performed by a qualified healthcare provider and that the pessary is fitted and inserted into the vagina. This code should not be reported for pessary cleaning and checking visits, unless the provider performs the necessary components of an evaluation and management (E/M) exam. Report CPT 57160 each time a new pessary is fitted and inserted for the same patient.

8. Historical information

CPT 57160 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A gynecologist fitting and inserting a pessary to treat vaginal wall prolapse in a patient.
2. A urologist inserting an intravaginal support device to help with stress urinary incontinence in a patient.
3. A healthcare provider fitting and inserting a pessary to provide support for the rectum in a patient with rectal prolapse.
4. A gynecologist inserting a pessary to deliver medication to the vagina for a patient with a specific medical condition.
5. A healthcare provider fitting and inserting a pessary to correct uterine prolapse in a patient.
6. A urologist fitting and inserting an intravaginal support device to provide support for the bladder in a patient with bladder prolapse.
7. A gynecologist fitting and inserting a pessary to help with stress urinary incontinence in a patient.
8. A healthcare provider inserting an intravaginal support device to provide support for the rectum in a patient with rectal prolapse.
9. A urologist fitting and inserting a pessary to deliver medication to the vagina for a patient with a specific medical condition.
10. A healthcare provider fitting and inserting a pessary to correct vaginal wall prolapse in a patient.