How To Use CPT Code 57700

CPT 57700 describes the procedure of cerclage of the uterine cervix, specifically for nonobstetrical purposes. This article will provide an overview of CPT 57700, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 57700?

CPT 57700 is a code used to describe the cerclage procedure performed on the uterine cervix. This procedure involves using stitching to repair a defect in the cervix before the patient becomes pregnant. It is important to note that this procedure is nonobstetrical, meaning it is not performed during pregnancy.

2. Official Description

The official description of CPT code 57700 is: ‘Cerclage of uterine cervix, nonobstetrical.’

3. Procedure

1. The patient is placed in the lithotomy position, with knees bent and spread apart using stirrups.
2. A speculum is inserted into the vaginal canal to provide access to the cervix.
3. A general anesthetic is administered to the patient.
4. The provider uses a uterine sound to locate the defect in the cervical wall.
5. A transverse vaginal incision is made at the junction of the vaginal wall and cervix.
6. The provider dissects the bladder from the cervix to expose the defect.
7. The unhealthy cervical tissue is excised using a knife.
8. The provider closes the opening in two layers using sutures.
9. A uterine sound is used again to ensure the vaginal canal was not closed during suturing.
10. The vaginal mucosa is brought back over the repaired area and sutured in place.
11. A vaginal pack may be inserted if necessary.

4. Qualifying circumstances

CPT 57700 is performed on patients who have had previous miscarriages due to cervical incompetence. It is used to prevent future miscarriages by repairing a defect in the cervix. This procedure is typically performed when there is evidence of trauma to the cervix or an anatomical abnormality. It is important to note that women who undergo this procedure must deliver any future babies via cesarean delivery.

5. When to use CPT code 57700

CPT code 57700 should be used when performing a nonobstetrical cerclage procedure on the uterine cervix. It is important to note that this procedure is not performed during pregnancy. If the cerclage is performed during pregnancy, a different CPT code should be used.

6. Documentation requirements

To support a claim for CPT 57700, the following documentation is required:

• Documentation of the patient’s previous miscarriages due to cervical incompetence
• Verification of the defect in the cervical wall using a uterine sound
• Date and time of the procedure
• Details of the procedure, including the incision, excision of unhealthy tissue, and suturing
• Confirmation that the vaginal canal was not closed during suturing
• Documentation of any additional procedures, such as the insertion of a vaginal pack

7. Billing guidelines

When billing for CPT 57700, it is important to ensure that the procedure is nonobstetrical and performed on the uterine cervix. It should not be reported with other codes related to obstetrical cerclage procedures. It is recommended to check with the payer for any specific documentation requirements before submitting the claim.

8. Historical information

CPT 57700 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient with a history of cervical incompetence undergoes a nonobstetrical cerclage procedure to repair a defect in the cervix.
2. A provider performs a nonobstetrical cerclage on a patient with an anatomical abnormality in the cervix to prevent future miscarriages.
3. A woman who has experienced trauma to the cervix in the past undergoes a nonobstetrical cerclage procedure to reduce the risk of miscarriage.
4. A patient with a history of previous miscarriages due to cervical incompetence undergoes a nonobstetrical cerclage to increase the chances of a successful pregnancy.
5. A provider performs a nonobstetrical cerclage on a patient with a defect in the cervical wall to prevent future pregnancy complications.
6. A woman with a history of cervical trauma undergoes a nonobstetrical cerclage procedure to improve the chances of a healthy pregnancy.
7. A patient with an anatomical abnormality in the cervix undergoes a nonobstetrical cerclage to reduce the risk of preterm labor.
8. A provider performs a nonobstetrical cerclage on a patient with a history of previous miscarriages to increase the chances of a successful pregnancy.
9. A woman with a defect in the cervical wall undergoes a nonobstetrical cerclage procedure to prevent future pregnancy complications.
10. A patient with cervical incompetence undergoes a nonobstetrical cerclage to improve the chances of a healthy pregnancy.