2025 HCPCS code S2405

Repair of sacrococcygeal teratoma in a fetus, performed in utero.

Appropriate coding requires accurate documentation reflecting the specific procedural steps involved, and whether it was a complete or partial removal of the SCT.The code should be utilized only when the surgical procedure is performed entirely in utero.Use of other codes may be required if complications occur and are treated during or after the main procedure.

Modifiers may be applicable depending on the circumstances of the service delivery.Consult payer specific guidelines for modifiers allowed.

Medical necessity for S2405 is established when the SCT poses a significant threat to fetal life or well-being. This might include compression of vital organs, increased risk of hydrops fetalis, or potential for severe complications during delivery.The decision to proceed should be based on a multidisciplinary team approach, taking into account the gestational age, size and location of the tumor, and fetal viability.

The clinical responsibility rests with the surgeon performing the fetal surgery. This includes pre-operative assessment, surgical planning, execution of the procedure (including making the uterine incision, excising the tumor, and closing the incisions), and post-operative monitoring of both the mother and the fetus.Anesthesiology services would also be involved.

In simple words: This code describes a surgery to remove a tumor (sacrococcygeal teratoma or SCT) from a baby while it's still in the mother's womb. The doctor makes a small cut in the womb, removes the tumor, and then closes the cut.

This HCPCS code, S2405, represents the surgical repair of a sacrococcygeal teratoma (SCT) in a fetus during pregnancy (in utero).The procedure involves a small incision in the uterus to access the fetus, excision of the SCT at the base of the fetal spine, and closure of the uterine incision. The fetus remains in the uterus for the remainder of the gestation period.

Example 1: A 28-year-old pregnant woman at 22 weeks gestation is diagnosed with a large sacrococcygeal teratoma in her fetus via ultrasound.The size of the teratoma is causing compression of the fetus's organs and poses a significant risk to the fetus's survival. Fetal surgery using code S2405 is deemed medically necessary., A 35-year-old woman at 26 weeks gestation has a smaller SCT detected in her fetus. While not immediately life-threatening, there's a risk of the tumor growing and causing complications during delivery.The decision is made to perform a minimally invasive in utero surgical removal using S2405., A 24-year-old woman presents at 20 weeks gestation with a fetal SCT. After reviewing the imaging and fetal viability, it is decided that the risk associated with the in utero procedure outweighs the benefits. The case is discussed with the parents, and the decision is made to closely monitor the SCT during gestation with plans to address after delivery.

Detailed prenatal ultrasound images demonstrating the size and location of the SCT, confirmation of fetal viability, complete maternal health history, informed consent documenting the risks and benefits of the procedure, operative notes detailing the surgical approach, the size and location of the SCT, and post-operative care.Post-operative ultrasound images of the fetus are also crucial.

** This code is not reimbursable by Medicare.Private payers have varying policies regarding coverage.Pre-authorization may be required in many cases.

  • Payment Status: Active (Non-Medicare)
  • Modifier TC rule: Not Applicable
  • Specialties:Fetal Surgery, Maternal-Fetal Medicine, Obstetrics, Neonatology
  • Place of Service:Inpatient Hospital, Ambulatory Surgical Center
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