2025 CPT code 56700
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Partial hymenectomy or revision of the hymenal ring.
Modifiers may be applicable depending on the circumstances of the procedure (e.g., 51 for multiple procedures, 22 for increased procedural services, 52 for reduced services, etc.). Consult appropriate modifier guidelines.
Medical necessity is established when the hymenal abnormality significantly impacts sexual function (dyspareunia) or menstrual flow.Documentation should support the clinical indication for the procedure.
The physician performs the procedure, including patient positioning, anesthesia administration, incision, excision or revision of the hymen, and suturing.
In simple words: This procedure either partially removes or reshapes a thin membrane at the entrance of the vagina (hymen).A local anesthetic is used to numb the area, and stitches are used to close the incisions.
This procedure involves either partial removal of the hymenal membrane or revision of the hymenal ring. The patient is positioned in the dorsal lithotomy position, and local anesthetic is injected.The perineum is prepped and draped, the labia retracted, and tissue forceps are used to grasp the hymenal tags. An incision is made to open the vaginal canal.Part of the hymenal membrane is excised, completely separating it from the vaginal opening. For hymenal ring revision, the ring of tissue within the labia and vaginal canal is revised.Finally, the cut margins are sutured.
Example 1: A young woman experiences dyspareunia (painful intercourse) due to an imperforate hymen.A partial hymenectomy is performed to create an opening., A woman presents with a significantly constricted hymenal ring impacting menstruation and sexual function.Surgical revision of the hymenal ring is performed to improve both., During a hysteroscopy, minor damage to the hymen occurs.Repair of the hymen is performed using code 56700.
* Thorough history and physical examination documenting the indication for the procedure (e.g., dyspareunia, menstrual difficulties, or damage during another procedure).* Operative report detailing the procedure performed, including the extent of the hymenectomy or revision.* Anesthesia record.* Pathology report (if applicable).* Post-operative notes.
** Hymenectomy and hymenotomy are often used interchangeably.However, hymenectomy implies complete removal, while hymenotomy refers to making an incision or creating an opening. Code 56700 typically describes a partial hymenectomy or revision.The distinction is crucial for accurate coding.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: TC modifier is not applicable.
- Specialties:Obstetrics and Gynecology
- Place of Service:Office, Ambulatory Surgical Center, Hospital Outpatient