CPT 57180 Vaginal Hemostasis Reimbursement | OpenPayer

Summary & Overview

CPT 57180: Vaginal Hemostasis by Insertion of Hemostatic Agent or Pack

CPT code 57180 denotes the insertion of a hemostatic agent or placement of a gauze pack into the vagina to control bleeding when the hemorrhage is not related to pregnancy or childbirth. Nationally, this code captures an acute, often urgent gynecologic intervention used across emergency departments, hospital outpatient departments, and ambulatory procedural settings to achieve local hemostasis. Proper coding supports clinical documentation, claims adjudication, and tracking of gynecologic bleeding interventions.

Key payers reviewed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage patterns, common modifiers used with the code, and clinical context for when the service is performed. The publication provides benchmarking and policy-relevant information such as reimbursement considerations, coding guidance nuances, and documentation elements that influence claims processing. It also highlights areas where national guidance or payer policies may affect utilization and payment. Data not available in the input will be identified explicitly where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare57180CPTvaginal hemostasisgynecology proceduresbleeding controloutpatient proceduresED proceduresclinical coding

Billing Code Overview

CPT code 57180 describes the insertion of a hemostatic agent or placement of a gauze pack into the vagina to control non-pregnancy-related vaginal bleeding. This procedure is intended to achieve local hemostasis through topical agents or tamponade.

Service type: Hemostatic control procedure for vaginal bleeding
Typical site of service: Hospital outpatient department, emergency department, or ambulatory surgical/clinical setting where vaginal procedures are performed

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 48-year-old woman presents to the emergency department with acute vaginal bleeding not related to pregnancy or recent childbirth. She reports sudden onset of moderate-to-heavy bleeding with lightheadedness. Vital signs are assessed, a focused pelvic exam is performed, and point-of-care hemoglobin is obtained. After visualization identifies a bleeding source amenable to topical control, the provider performs placement of a vaginal gauze pack and/or inserts a topical hemostatic agent to tamponade bleeding and promote clot formation. The procedure is typically performed in an ambulatory clinic, emergency department, or outpatient gynecology procedure room under local anesthesia or topical analgesia. The clinical workflow includes consent, hemostasis procedure, observation for recurrent bleeding, instruction for pack removal or follow-up, documentation of the bleeding source and hemostatic material used, and scheduling follow-up gynecologic evaluation or removal of packing within a specified timeframe.

Coding Specifications

Modifier	Description	When to Use
`00`	No modifier (unmodified service)	Use when no additional modifier applies and service is reported as usual.
`11`	Office or other outpatient visit

CPT 57155: Gynecologic Brachytherapy, Uterine and Cervical Implant

CPT-57170-DIAPHRAGM-CERVICAL-CAP-FITTING-AND-INSTRUCTION

CPT 57170: Diaphragm or Cervical Cap Fitting and Instruction

CPT-57156-VAGINAL-BRACHYTHERAPY-APPLICATOR-PLACEMENT

CPT 57156: Vaginal Applicator Placement for Brachytherapy

CPT-57160-PESSARY-FITTING-AND-INSERTION-VAGINAL-PROLAPSE

CPT 57160: Pessary Fitting and Insertion for Vaginal Wall Prolapse

CPT-57150-VAGINAL-CANAL-WASHOUT-MEDICATION-INSTILLATION

CPT 57150: Vaginal Canal Washout with Medication Instillation

Taxonomy Code	Specialty	Notes
207Q00000X	Obstetrics & Gynecology	Gynecologists frequently perform vaginal packing or topical hemostatic placement for non-obstetric vaginal bleeding.
207R00000X	Family Medicine	Family physicians in ambulatory or urgent care settings may perform this procedure for acute bleeding control.
208000000X	Emergency Medicine	Emergency physicians commonly perform prompt hemostatic measures for acute non-obstetric vaginal bleeding.
363L00000X	Womens Health Nurse Practitioner	Advanced practice clinicians in women's health often manage packing and hemostatic agent placement.
363A00000X	Certified Nurse Midwife	Midwives in outpatient settings may perform hemostatic packing for non-pregnancy-related bleeding.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`N93.9`	Abnormal uterine and vaginal bleeding, unspecified	Common presenting diagnosis for non-pregnancy-related vaginal bleeding requiring topical hemostasis.
`N93.8`	Other specified abnormal uterine and vaginal bleeding	Used when a specified non-obstetric cause of bleeding is identified that does not fit other categories.
`N76.0`	Acute vaginitis	Vaginal infection causing bleeding or friable tissue that may respond to topical hemostatic measures.
`N76.1`	Subacute and chronic vaginitis	Chronic inflammation sometimes presents with intermittent bleeding managed with local hemostasis.
`K64.8`	Other hemorrhoids (analogous for mucosal bleeding sites)	Not directly gynecologic but listed to illustrate mucosal bleeding management parallels (omit if disallowed).
`R58`	Hemorrhage, not elsewhere classified	General code for significant bleeding when site-specific code is not selected.
`D72.8`	Other specified disorders of white blood cells (coagulopathy-related codes may be relevant)	Used when bleeding is exacerbated by hematologic disorders affecting clotting.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`57454`	Colposcopy of the cervix including upper/adjacent vagina when performed; with biopsy(s) and endocervical curettage	Performed before or after hemostatic packing if cervical lesions or active cervical bleeding are suspected.
`57500`	Biopsy, single or multiple, any method, of the vulva; simple	May be performed if a vulvar lesion is identified as the bleeding source during evaluation.
`58260`	Drainage of uterine hematoma, not C-section related	Performed if deeper pelvic or uterine source is suspected and evacuation is required after initial topical measures.
`52000`	Cystourethroscopy, with or without irrigation and/or brush biopsy	Used when urinary tract source of bleeding is considered in differential; often part of diagnostic workup.
`99070`	Supplies and equipment unusual; used for items not included in procedure	Reported for specific hemostatic agents or specialized packing materials if not included in the base procedure.

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