Summary & Overview
CPT 0669T: Donor Uterus Preparation with Venous Anastomosis
CPT code 0669T represents the surgical preparation of a donor uterus, from a cadaver or living donor, with creation of a venous anastomosis to enable transplantation. As uterine transplantation programs expand and surgical techniques mature, accurate reporting for donor-organ preparation is important for clinical registries, surgical quality measurement, and payer adjudication. Nationally, this code captures a specialized, high-complexity surgical service performed in the operating room as part of the organ procurement/transplant workflow.
Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the code’s clinical intent and service setting, common modifiers associated with surgical services, and the context needed for billing workflows and claims submission. Where available, coverage patterns, reimbursement benchmarks, and policy guidance affecting transplant-related donor procedures are summarized to inform administrative and clinical stakeholders. The publication also highlights areas where documentation and coding specificity affect claims processing and where further payer policy clarification may be needed. Data not available in the input is noted explicitly where applicable.
Billing Code Overview
CPT code 0669T describes the surgical preparation of a donor uterus from a cadaveric or living donor for transplantation, specifically including creation of a venous anastomosis (connection). This procedure is part of donor organ procurement and preparation to enable uterine transplantation.
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Service type: Surgical donor organ preparation for transplantation
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Typical site of service: Operating room or surgical suite during organ procurement or transplant surgery
Clinical & Coding Specifications
Clinical Context
A typical patient scenario involves procurement and preparation of a donor uterus from either a deceased (cadaveric) or living donor to enable uterine transplantation. The donor is evaluated in an operating room or organ procurement setting under general anesthesia. The surgical team dissects vascular pedicles and prepares a venous anastomosis on the donor uterus for subsequent transplant into the recipient. The workflow includes donor selection and consent, intraoperative organ procurement (including 0669T to prepare the venous outflow), specimen preservation and transport, and handoff to the recipient transplant team. Typical site of service is an acute care hospital operating room or an organ procurement organization facility. The donor case is coordinated with recipient scheduling, perfusion and preservation protocols, and transplant team logistics for timely implantation.
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 due to complexity (document rationale). |
51 | Multiple procedures | Use when 0669T is reported with other distinct surgical procedures performed during the same operative session on the donor. |
52 | Reduced services | Use when part of the preparation is partially performed or aborted, resulting in reduced work or scope. |
53 | Discontinued procedure | Use when the donor uterus preparation is started but discontinued for documented medical reasons. |
54 | Surgical care only | Use when reporting only the donor surgical preparation component and another provider reports postoperative management, if applicable. |
55 | Postoperative management only | Use when one provider reports only postoperative management of the donor after 0669T. |
56 | Preoperative management only | Use when one provider reports only preoperative evaluation and planning related to the donor procedure. |
62 | Two surgeons | Use when two surgeons of different specialties perform distinct parts of the donor uterus preparation and both are required. |
66 | Collaborative care | Use when multiple physicians from different specialties provide coordinated care for complex donor procurement. |
73 | Discontinued outpatient procedure prior to anesthesia | Use when donor uterus preparation is cancelled after anesthesia is initiated but before completion in an outpatient setting. |
78 | Return to operating room for related procedure during global period | Use when the donor requires reoperation related to the initial procurement within the global period. |
80 | Assistant surgeon | Use when an assistant surgeon provides significant intraoperative assistance during donor uterus preparation. |
81 | Minimum assistant surgeon | Use when a minimal assistant surgeon role is documented. |
82 | Assistant surgeon (when qualified resident surgeon not available) | Use when an assistant surgeon is needed because a qualified resident is not available. |
AS | Physician assistant, nurse practitioner, or clinical nurse specialist service | Use when an advanced practice clinician performs or assists in the donor preparation under applicable rules. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2080P0207X | Obstetrics & Gynecology | Gynecologic surgeons experienced in uterine surgery and transplantation. |
| 2080P0800X | Reproductive Endocrinology | Specialists coordinating reproductive indications and donor selection. |
| 2084P0901X | Transplant Surgery | Surgeons specializing in abdominal and pelvic organ transplantation; lead or assist in procurement. |
| 207L00000X | General Surgery | General surgeons who may participate in donor procurement and vascular anastomosis preparation. |
| 207W00000X | Vascular Surgery | Vascular surgeons who may be called for complex venous anastomosis preparation and reconstruction. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
| Data not available in the input. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
0191T | Procurement of solid organ from deceased donor for transplant; uterus | Performed during donor procurement and often precedes or encompasses 0669T when whole-organ retrieval is billed separately. |
33533 | Coronary artery bypass, non-transplant analog (example of vascular anastomosis technique) | Provides context for complex vascular anastomosis coding; not uterus-specific but reflects coding for operative vascular connections. |
34830 | Heart transplantation, donor cardiectomy and cardiac preparation | Analogous donor organ preparation procedure coding and donor operative workflow; used for comparative billing and workflow mapping. |
38500 | Biopsy or excision of lymph node(s) | May be performed concurrently in donor evaluation during procurement when nodal assessment is required. |
99100 | Anesthesia for patient of extreme age, younger than 1 or older than 70 | Example of anesthesia-related additive code relevant when donor or recipient age qualifiers modify perioperative care; included for anesthesia planning context. |