Fetal surgery typically involves opening the gravid uterus (with either a traditional Cesarean surgical incision or through single or multiple fetoscopic port incisions), surgically correcting a fetal abnormality, and returning the fetus to the uterus and restoring uterine closure.
Vesico-amniotic shunting as a treatment of urinary tract obstruction may be considered medically necessary in fetuses under the following conditions:
Open in utero resection of malformed pulmonary tissue or placement of a thoraco-amniotic shunt may be considered medically necessary under the following conditions:
In utero removal of sacrococcygeal teratoma (SCT) may be considered medically necessary under the following conditions:
In utero closure of myelomeningocele (MMC) may be considered medically necessary under the following conditions:
Fetal surgery is considered experimental/investigational for all other conditions including but not limited to those indicated below due to insufficient evidence of efficacy.
Covered Diagnosis Codes for Procedure Codes 59076 and S2401
Covered Diagnosis Codes for procedure codes 59076 and S2402
Covered Diagnosis Codes for Procedure Codes 59076 and S2403
Covered Diagnosis Codes for Procedure Code S2404
Covered Diagnosis Codes for Procedure Code S2405