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The CPT® Code 57307 refers to the surgical procedure for the closure of a rectovaginal fistula using an abdominal approach, which is typically indicated when the fistula is situated high in the rectum. Rectovaginal fistulas are abnormal connections between the rectum and the vagina, often resulting from conditions such as malignant neoplasms or complications arising from radiation therapy. The procedure involves making an incision in the lower abdomen to access the affected area. During the surgery, the rectovaginal septum is carefully dissected to identify the fistula. Once located, the fistula is divided, and the openings in both the rectum and vagina are meticulously closed with sutures to restore normal anatomy. In addition to the closure of the fistula, this specific code also includes the performance of a concomitant colostomy. This entails making a second incision in the abdomen to create an opening for the colostomy. The section of the intestine that is to be diverted is transected, and the distal segment is closed off. The proximal segment is then brought out through the skin to form a stoma, which is sutured to the skin, allowing for the placement of a colostomy bag over the stoma. This comprehensive approach addresses both the closure of the fistula and the necessary diversion of intestinal contents, ensuring effective management of the patient's condition.
© Copyright 2025 Coding Ahead. All rights reserved.
The procedure described by CPT® Code 57307 is indicated for the closure of rectovaginal fistulas, particularly when these fistulas are located high in the rectum. The common underlying causes for these types of fistulas include:
The procedure for CPT® Code 57307 involves several critical steps to ensure the successful closure of the rectovaginal fistula and the creation of a colostomy. The steps are as follows:
After the completion of the procedure, patients will require careful monitoring and post-operative care. This includes managing the colostomy, ensuring the stoma is functioning properly, and monitoring for any signs of complications such as infection or leakage. Patients may also need education on colostomy care and lifestyle adjustments following the surgery. Recovery time can vary based on individual health factors and the extent of the surgery performed.
| Short Descr | FISTULA REPAIR & COLOSTOMY | Medium Descr | CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST | Long Descr | Closure of rectovaginal fistula; abdominal approach, with concomitant colostomy | 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 | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 72 - Colostomy, temporary and permanent |
| 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). | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| Pre-1990 | Added | Code added. |
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