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The construction of an artificial vagina, as described by CPT® Code 57292, is a surgical procedure aimed at addressing the congenital absence of the vagina. This condition can significantly impact an individual's quality of life, necessitating surgical intervention to create a functional vaginal canal. The procedure involves the use of a tissue graft, which distinguishes it from similar procedures that do not utilize grafting techniques, such as CPT® Code 57291. The surgical approach typically includes making an H-shaped incision between the urethra and rectum, followed by the careful creation of a cavity. The presence of a functioning uterus influences the extent of the cavity's creation, as it may extend to the lowest pole of the uterine cavity. In cases where the uterus is absent, the cavity is developed up to the peritoneum. The procedure also incorporates measures to control bleeding, such as electrocoagulation, and involves the placement of a vaginal stent to maintain the newly formed cavity. The application of a tissue graft, which can be a full or split thickness skin graft harvested from the buttocks or upper thigh, is a critical component of this procedure. The graft is secured in place using sutures and is retained with an obturator until healing is adequate. Post-operative care includes the use of a polyfoam dilator to ensure the graft site remains open and promotes healing.
© Copyright 2025 Coding Ahead. All rights reserved.
The construction of an artificial vagina with grafting, as indicated by CPT® Code 57292, is performed primarily for the treatment of congenital absence of the vagina. This condition may present in various forms and can lead to significant physical and psychological challenges for the affected individual. The procedure is indicated in cases where the absence of the vagina is confirmed, and surgical intervention is deemed necessary to create a functional vaginal canal.
The procedure for the construction of an artificial vagina with graft involves several critical steps that ensure the successful creation of a functional vaginal canal.
Post-procedure care is crucial for the success of the artificial vagina construction with graft. Patients are required to use a polyfoam dilator daily, which helps to keep the newly formed vaginal canal open and supports the healing process of the graft. The dilator should be inserted for a duration of 10-12 hours each day. Monitoring for any signs of complications, such as infection or graft failure, is essential during the recovery period. Follow-up appointments with the healthcare provider will be necessary to assess healing and to make any adjustments to the post-operative care plan as needed.
| Short Descr | CONSTRUCT VAGINA WITH GRAFT | Medium Descr | CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT | Long Descr | Construction of artificial vagina; with graft | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 132 - Other OR therapeutic procedures, female organs |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | GC | This service has been performed in part by a resident under the direction of a teaching physician | KX | Requirements specified in the medical policy have been met |
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