Summary & Overview
CPT 57022: Incision and Drainage of Vaginal Wall Hematoma with Foley Catheter
CPT code 57022 covers incision and drainage of a vaginal wall hematoma in a pregnant or recently postpartum patient with placement of a Foley catheter for continued drainage. This is an acute obstetric/gynecologic surgical procedure used to manage symptomatic or expanding hematomas that can threaten maternal health or complicate postpartum recovery. Nationally, timely diagnosis and appropriate procedural management under this code help reduce complications such as infection, ongoing hemorrhage, and prolonged hospitalization.
Key payers referenced in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication provides a concise overview of coding context, clinical indications, common sites of service, and payer coverage considerations. Readers will find benchmark descriptions for typical utilization patterns, guidance on billing documentation elements required to support medical necessity, and a clinical context summary explaining when this procedure is typically performed. Data not available in the input is clearly identified where applicable.
This summary is intended for a national audience of coding professionals, clinicians, and revenue cycle stakeholders seeking a practical briefing on CPT code 57022, its clinical use, and the payer landscape relevant to surgical management of vaginal wall hematomas.
Billing Code Overview
CPT code 57022 describes the surgical incision and drainage of a hematoma of the vaginal wall in a pregnant patient or a patient who has recently delivered, with placement of a Foley catheter for continued drainage. This procedure is a targeted obstetric/gynecologic surgical intervention to evacuate a localized collection of blood within the vaginal wall and to maintain postoperative drainage.
-
Service type: Surgical evacuation and drainage of vaginal wall hematoma with indwelling urinary catheter management
-
Typical site of service: Inpatient or outpatient surgical suite within a hospital or birthing center, or an obstetrics/gynecology procedural area
Clinical & Coding Specifications
Clinical Context
A typical patient is a woman in the immediate postpartum period or late in pregnancy who develops a localized vaginal wall hematoma with persistent pain, pressure, swelling, or ongoing bleeding. Presentation often occurs in the labor and delivery unit, obstetric triage, or postpartum recovery. Initial assessment includes vital signs, focused pelvic exam, hematoma size and expansion assessment, and hemodynamic stability evaluation. Imaging (transvaginal ultrasound or pelvic ultrasound) may be used if location/extent is unclear. When the hematoma is tense, expanding, or causing significant symptoms, the obstetrician/gynecologist performs incision and drainage of the vaginal wall hematoma under appropriate anesthesia (local with sedation, regional block, or general anesthesia depending on patient status and coexisting procedures). After evacuation of clotted blood and hemostasis, a Foley catheter (vaginal or intra-cavitary) is placed for continuous drainage and to prevent reaccumulation. Postprocedure care includes monitoring for hemorrhage, vital sign surveillance, analgesia, and antibiotic prophylaxis based on institutional protocol. Documentation should include indication, size and location of the hematoma, anesthesia type, estimated blood loss, method of hemostasis, catheter type and size, and patient response.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Provider performed the service | Use for standard, uncomplicated performance when reporting the usual service. |