# Vaginoscopy with Cystoscopy



## lahnamiller (Oct 16, 2017)

I have a group of urologists that have started out on their own.  They do a lot of cystoscopies with vaginoscopies when there is some undetermined vaginal bleeding.  They do NOT use a colposcope to do the vaginoscopy.  There is no actual CPT code that I can find for a vaginoscopy.  Can the 57420 be used to bill out a vaginoscopy even if the Dr. does not utilize the colposcope?
They also do pediatric vaginoscopies for the same reason sometimes.  Would it be billed as 57420 also?

Any help and guidance would be greatly appreciated!


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## eutsler (Oct 16, 2017)

what sort of scope are they using then?


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## lahnamiller (Oct 16, 2017)

From my understanding the providers are using the same type of scope that they would use for the cystoscopy or for a laparoscopy.  I do have a message out to them to double check this information.


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## eutsler (Oct 17, 2017)

https://www.ncbi.nlm.nih.gov/pubmed/14634408

Did you see this? This doesn't answer the question, but it's interesting.

I also found this, which might or might not be helpful.  Maybe try an unlisted code and compare to 57420?
https://www.augs.org/clinical-practice/archived-coding-questions/

here’s what the American Urogynecologic Society (AUGS) has on their website

Q: I used a ureteroscope to look at periurethral tunnels left from an old pubovaginal sling. Patient had a retropubic fistula from the vagina to the mons along the old pubovaginal sling track (which used permanent sutures and gortex pledgets). Vaginoscopy with the ureteroscope is not a CPT code. Would I be able to bill and EM for the time since this was an extensive version of an exam?

A: Per the AUGS Coding Committee, A CPT code does not exist for vaginoscopy with a ureteroscope, and therefore,  this is not a billable service.  There is no CPT code of vaginoscopy.  The closest would be colposcopy of the vagina, but this is performed with a colposcope, and the code description stipulates that the entire vagina is surveyed, which is not what you describe.  Therefore, this would not be an appropriate code either.


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## lahnamiller (Oct 18, 2017)

Thanks!  I had not seen the first but I had seen the second.  I think we will try as you suggest and bill as an unspecified with comparison to the 57420 and possibly use the other documentation as some supporting documentation as this is why it is done most of the time.

Thanks again for the help!


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