2025 CPT code 57170
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Female Genital System Surgery Feed
Fitting of a diaphragm or cervical cap, with instructions for self-insertion.
Modifiers may be applicable depending on the circumstances of the service. Consult the CPT manual and payer-specific guidelines for appropriate modifier use.
Medical necessity for a diaphragm or cervical cap fitting is established based on the patient's request for birth control or need for a device for artificial insemination.Documentation should support the patient's choice and the appropriateness of the device for their individual circumstances.
The provider's responsibility includes selecting and fitting the appropriate diaphragm or cervical cap, providing detailed instructions on self-insertion, and explaining the device's purpose and limitations (contraceptive or non-contraceptive).
In simple words: The doctor helps you fit a diaphragm or cervical cap and teaches you how to put it in yourself. A diaphragm prevents pregnancy by blocking sperm from entering the uterus. A cervical cap is used to collect menstrual fluid or to help with artificial insemination; it's not a contraceptive.
This procedure involves fitting a patient with a diaphragm or cervical cap and providing education on self-insertion techniques.The provider inserts a fitting ring (for diaphragm) into the vagina, covering the uterine opening, selecting the largest comfortably fitting size.For cervical caps, the provider ensures proper fit and covers the cervix to prevent pregnancy or facilitate artificial insemination.Instructions include spermicide use (if applicable) and proper insertion/positioning techniques.
Example 1: A 28-year-old female patient requests a diaphragm fitting as a birth control method. The provider performs a pelvic exam, selects the appropriate size diaphragm, and teaches the patient proper insertion and removal techniques, including the use of spermicide., A 35-year-old female patient is undergoing fertility treatments and requires a cervical cap fitting to facilitate artificial insemination. The provider fits the cap, ensures proper placement, and educates the patient on its use during the procedure., A 25-year-old female patient who has previously used a diaphragm requires a refitting due to weight changes. The provider reassesses the patient, selects a new size, and reviews insertion and care instructions.
* Patient's medical history, including allergies and previous pregnancies.* Pelvic examination notes documenting size and fit of the device.* Detailed instructions provided to the patient regarding insertion, removal, and maintenance of the device.* Documentation of patient understanding and demonstration of correct insertion technique.* Note regarding spermicide use if applicable.
** This code is for the fitting and instruction only.Separate codes may be necessary for additional services such as spermicide dispensing or counseling.
- Revenue Code: P6C
- Payment Status: Active
- Specialties:Obstetrics and Gynecology, Family Medicine
- Place of Service:Office