How To Use CPT Code 57283

CPT 57283 describes a specific procedure used to repair vaginal prolapse using an intra-peritoneal approach. This article will cover the official description, procedure details, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 57283?

CPT 57283 is a code that represents a surgical procedure performed to repair vaginal prolapse. It involves the use of an intra-peritoneal approach, specifically utilizing the uterosacral ligament or levator myorrhaphy technique. This code is used when the provider pulls up the vaginal vault that is prolapsing using a vaginal approach and attaches it to a ligament inside the peritoneal lining.

2. Official Description

The official description of CPT code 57283 is: ‘Colpopexy, vaginal; intra-peritoneal approach (uterosacral, levator myorrhaphy).’ It is important to note that this code should not be reported in conjunction with codes 57556, 58263, 58270, 58280, 58292, or 58294.

3. Procedure

1. The provider administers anesthesia and appropriately preps and drapes the patient.
2. In an intra-peritoneal vaginal vault suspension, the provider opens the vaginal mucosa at the apex of the vagina.
3. The provider dissects away the pubocervical and rectovaginal fascia from the vaginal wall, exposing the enterocele.
4. The provider identifies the peritoneum and enters it, retracting the bowel away and packing it with a laparotomy towel.
5. The provider identifies and palpates the ureters bilaterally to ensure they are not sutured.
6. The provider grasps the uterosacral ligaments with clamps and places them on traction.
7. The provider places a series of interrupted sutures through the uterosacral ligaments on both sides and pulls them together to plicate the ligaments.
8. The provider places sutures into the top of the anterior and posterior vaginal walls and anchors them into the plicated uterosacral ligaments.
9. If the provider uses the levator muscle, sutures are placed into this structure to create a shelf above the rectum, and sutures from the vaginal vault are tied into this shelf for support.
10. The provider performs culdoplasty to obliterate the cul-de-sac or enterocele.
11. The provider brings the sutures through the exposed pubocervical and rectovaginal fascia and ties them to suspend the vagina deep in the pelvis.
12. The provider closes the vaginal vault with interrupted sutures and places a Foley catheter for bladder drainage and packs the vagina with gauze.