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BETA v.3.0

2025 CPT code 57180

Introduction of any hemostatic agent or pack for spontaneous or traumatic nonobstetrical vaginal hemorrhage (separate procedure).

This code is a separate procedure and should not be reported with other procedures performed on the genital organs during the same encounter unless it is a significant and separately identifiable service.

Modifiers may be applicable to this code, such as modifier 22 (Increased Procedural Services) if the procedure is unusually complex or modifier 52 (Reduced Services) if the procedure is discontinued.

Medical necessity for this code is established by the presence of non-obstetrical vaginal bleeding that requires intervention.

The physician is responsible for placing the patient in the dorsal lithotomy position, inspecting the vagina with a speculum, and inserting the hemostatic agent or pack.

In simple words: This procedure involves placing a substance or a pack into the vagina to stop bleeding that's not related to pregnancy or childbirth. The doctor uses a tool to hold the vaginal walls open and then inserts the hemostatic agent or pack to help the blood clot and stop the bleeding.

This code describes a procedure where a hemostatic agent (a substance that helps stop bleeding) or a pack is inserted into the vagina to control bleeding that is not related to pregnancy or childbirth. The bleeding may be spontaneous or due to an injury.

Example 1: A patient presents with non-obstetrical vaginal bleeding due to a vaginal laceration. The physician inserts a hemostatic agent to control the bleeding., A patient experiences spontaneous vaginal bleeding after menopause. The physician packs the vagina with gauze to stop the bleeding., A patient undergoing a gynecological procedure experiences bleeding from the vaginal wall. The physician applies a hemostatic agent to achieve hemostasis.

Documentation should include the cause of the bleeding, the type of hemostatic agent or pack used, the amount of blood loss, and the patient's response to the procedure.

** Payers may bundle this code into other procedures performed on the genital organs during the same encounter unless it is a stand-alone procedure.

** Only Enterprise users with EHR integration can access case-specific answers. Click here to request access.

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