2025 CPT code 57160

Fitting and insertion of a pessary or other intravaginal support device.

Consult the current CPT manual for the most up-to-date coding guidelines and conventions.

Modifiers may be applicable depending on the circumstances of the procedure. Consult the CPT manual for guidance on modifier usage.

Medical necessity is established by symptoms related to pelvic organ prolapse, such as pelvic pressure, bulging, urinary or bowel dysfunction, or vaginal bleeding. The pessary is a conservative treatment option that provides support and alleviates symptoms.

The provider performs a pelvic exam, determines the appropriate pessary type and size, inserts the pessary, checks for incontinence, and provides patient education on pessary insertion, removal, and cleaning.Follow-up exams are performed to ensure proper placement and function.

IMPORTANT For pessary supplies, report HCPCS codes A4561 (rubber) or A4562 (silicone).Code 57160 is billed once per pessary fitting; subsequent visits for cleaning and checks should use an E/M code unless a new pessary is fitted.

In simple words: The doctor inserts a small device (pessary) into the vagina to support the vaginal walls or other pelvic organs.They check the fit, make sure it's comfortable, and teach you how to clean and care for it.

This procedure involves the fitting and insertion of a pessary or similar intravaginal support device to treat vaginal wall prolapse or other pelvic floor disorders.The provider performs a vaginal examination to determine the appropriate pessary type and size, potentially trying multiple sizes to achieve a proper fit.Post-insertion, the provider assesses for incontinence and provides instructions on pessary insertion, removal, and cleaning.A follow-up examination ensures the pessary remains correctly positioned.

Example 1: A 60-year-old woman presents with symptoms of pelvic organ prolapse.After examination, a ring pessary is fitted.The patient is instructed on proper hygiene and care. A follow-up appointment is scheduled for pessary assessment., A 72-year-old woman with recurrent urinary incontinence undergoes a pessary fitting.A Gellhorn pessary is chosen due to the severity of the prolapse.The patient is educated on self-insertion and removal techniques and schedules a follow-up appointment., A 55-year-old woman experiences vaginal discomfort and bleeding.After examination, a U-shaped pessary is fitted to provide support. Post-insertion, there are no complications, and the patient learns pessary care instructions.

Detailed history and physical examination documenting the presence of pelvic organ prolapse or other indications for pessary use.Documentation of pessary type and size, insertion technique, patient education provided, and any post-insertion assessments (e.g., incontinence check).

** Consider additional codes for associated services (e.g., E/M codes for follow-up visits). Always adhere to payer-specific guidelines and local coverage determinations.

  • Revenue Code: P6C (Medicare Fee Schedule: MINOR PROCEDURES - OTHER)
  • RVU: Unknown
  • Global Days : Unknown
  • Payment Status: Active
  • Modifier TC rule: Unknown
  • Fee Schedule : Unknown
  • Specialties:Gynecology, Urogynecology
  • Place of Service:Office, Outpatient Hospital, Ambulatory Surgical Center
** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.