Summary & Overview
CPT 0668T: Donor Uterus Preparation for Transplantation
CPT code 0668T covers the surgical preparation of a donor uterus—either from a cadaveric or living donor—for transplantation, including dissection of soft tissues and preparation of uterine arteries and veins. As uterine transplantation evolves, a distinct code for donor uterus preparation standardizes billing and supports clinical reporting for a rare but growing transplant modality. Nationally, this code matters because it enables clearer tracking of resource use and procedural prevalence for reproductive organ transplantation.
Key payers examined include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical service captured by the code, common billing modifiers and service-line context, and a summary of payer coverage patterns and typical reimbursement considerations when available. The publication also outlines relevant clinical context for organ procurement workflows and expected sites of service.
This analysis focuses on benchmarks and policy-relevant issues affecting billing for donor uterus preparation, including coding clarity, payer recognition of uterus procurement services, and implications for transplant program documentation and billing consistency.
Billing Code Overview
CPT code 0668T describes the preparation of a donor uterus from a cadaveric or living donor for transplantation. This surgical service includes dissecting and removing soft tissues and preparing the uterine arteries and veins to make the organ suitable for transfer to a recipient.
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Service type: Surgical procurement and organ preparation for transplantation
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Typical site of service: Operative suite or specialized organ procurement facility
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves procurement of a donor uterus from either a deceased (cadaveric) donor or a living donor as part of a uterine transplant program. The donor is evaluated in the operating room by a transplant surgeon and surgical team. For a cadaveric donor, the team coordinates with the organ procurement organization, confirms donor suitability, performs intraoperative dissection to isolate the uterus with its vascular pedicles (uterine arteries and veins), and prepares the specimen for rapid transport and transplantation. For a living donor, the procedure requires elective preoperative planning, informed consent, imaging to map vascular anatomy, and a planned operative dissection to remove the uterus while controlling blood loss and preserving vascular conduits for transplantation.
Preoperative workflow includes donor medical evaluation, crossmatching, infectious disease testing, and surgical planning with vascular imaging. Intraoperative workflow includes laparotomy or minimally invasive access, meticulous dissection of soft tissues, identification and preservation of uterine arteries and veins, ligation or division of surrounding structures as indicated, hemostasis, organ perfusion with preservation solution, and packaging for transport. Post-procurement tasks include operative documentation, specimen labeling, communication with transplant and receiving teams, and transfer to the transport team or surgical back table for implantation preparation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
22 | Increased procedural services | Use when work required to prepare the donor uterus is substantially greater than typical (e.g., extensive adhesiolysis, complex vascular dissection). |
51 | Multiple procedures | Use when multiple unrelated procedures are billed at the same operative session for the donor (if payer allows). |
52 | Reduced services | Use when the preparation is partially reduced or not completed as described (e.g., aborted because of donor instability). |
53 | Discontinued procedure | Use when the procurement is started but terminated for extenuating circumstances prior to completion. |
54 | Surgical care only | Use when billing only for the donor surgical care portion and another provider bills for postoperative care (rare for procurement). |
55 | Postoperative management only | Use if a different provider bills only for postoperative management of the donor. |
56 | Preoperative management only | Use when billing is limited to preoperative management of the donor. |
62 | Two surgeons | Use when two surgeons with distinct skills jointly perform the donor uterus preparation and documentation supports shared work. |
66 | Surgical team | Use when a surgical team approach is reported by a designated team leader and members per payer rules. |
73 | Discontinued outpatient/ambulatory before anesthesia | Use when the procedure is discontinued in the ambulatory setting before anesthesia administration. |
78 | Unplanned return to OR after initial procedure for a related procedure | Use when the donor requires an unplanned return to the OR for a complication related to the procurement. |
80 | Assistant surgeon | Use when an assistant surgeon performs part of the procedure and documentation supports assistant work. |
81 | Minimum assistant surgeon | Use when minimal assistance is provided and payer recognizes this modifier. |
82 | Assistant surgeon (when a qualified resident not available) | Use when an assistant is required but a qualified resident is unavailable. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | Use when an advanced practice clinician assists at surgery and payer accepts AS for professional billing. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080P0206X | Transplant Surgery | Surgeons specializing in abdominal and pelvic organ transplantation who perform donor procurement. |
| 2080P0202X | General Surgery | General surgeons with transplant experience who may participate in donor procurement. |
| 2086S0122X | Obstetrics & Gynecology (Gynecologic Oncology/Complex Pelvic Surgery) | Gynecologic surgeons involved in uterine retrieval, vascular dissection, and anatomic expertise. |
| 2080S0122X | Vascular Surgery | Vascular surgeons who may assist with complex vascular dissection and vessel preparation. |
| 363L00000X | Transplant Coordinator/Procurement Specialist | Non-physician roles involved in organ procurement coordination and logistics (listed for team context). |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
N97.9 | Female infertility, unspecified | Uterine factor infertility is an indication for uterine transplantation when other fertility treatments have failed. |
N83.2 | Abscess of ovary and fallopian tube | Severe pelvic disease may lead to uterine damage or absence prompting consideration of transplant in select cases. |
Q51.9 | Congenital absence of uterus and cervix | Mayer-Rokitansky-Küster-Hauser syndrome is a common indication for uterine transplantation. |
N80.1 | Endometriosis of ovary | Extensive pelvic endometriosis can render the uterus nonfunctional or damage anatomy relevant to transplantation. |
C79.8 | Secondary malignant neoplasm of other specified sites (pelvic) | Prior pelvic malignancy with hysterectomy or uterine loss may be an indication for transplantation in highly selected scenarios. |
Z94.83 | Uterus transplant status | Used post-transplant to indicate status; relevant to donor-recipient matching and documentation. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0668T | Preparation of donor uterus from cadaver or living donor for transplantation; includes dissection and preparation of uterine arteries and veins | Primary procedure describing donor uterus preparation for transplant. |
0191T | Regional or general organ procurement (removal and surgical preparation of organs for transplantation) | Related procurement code for multiorgan donors; may be reported for broader organ recovery sessions that include the uterus when payers recognize. |
99223 | Initial hospital care, typically 70 minutes or more | Represents complex preoperative or immediate postoperative inpatient evaluation and management often provided for living donors or donor management. |
38220 | Bone marrow harvesting, allogeneic, from donor | Example of another organ/tissue procurement procedure; included for workflow similarity though different anatomic site. |
36415 | Collection of venous blood by venipuncture | Common ancillary service for donor infectious disease testing, blood typing, crossmatching prior to procurement. |
Note: When billing, verify payer-specific guidance on use of transplant procurement codes and bundling rules. For codes not directly provided in the input, clinical context was used to list commonly associated CPT services performed before, during, or after donor uterus preparation.