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A paravaginal defect repair is a surgical procedure aimed at correcting a specific type of pelvic floor disorder known as a paravaginal defect. This defect occurs when there is a loss of support in the arcus tendineus fascia pelvis (ATFP), which is a critical structure that provides lateral support to the vagina. When the ATFP is compromised, it can lead to the prolapse of the bladder and urethra, resulting in conditions such as cystocele (bladder prolapse) or cystourethrocele (prolapse of both the bladder and urethra). The procedure is performed using an open abdominal approach, which allows the surgeon to access the retropubic space of Retzius while ensuring the protection of surrounding vascular structures. During the surgery, the bladder is mobilized, and the lateral retropubic spaces are exposed to visualize the ATFP. The surgeon identifies the ischial spine and assesses the extent of the defect, which may be unilateral or bilateral. The repair involves suturing the fibromuscular tissue of the vaginal apex to the ATFP or obturator internus fascia, effectively restoring support to the pelvic structures. This procedure is essential for alleviating symptoms associated with pelvic organ prolapse and improving the quality of life for affected individuals.
© Copyright 2025 Coding Ahead. All rights reserved.
The paravaginal defect repair procedure is indicated for patients experiencing pelvic organ prolapse, specifically when there is a loss of support in the arcus tendineus fascia pelvis (ATFP). The following conditions may warrant this surgical intervention:
The paravaginal defect repair procedure involves several critical steps to ensure effective correction of the defect. The following outlines the procedural steps:
After the paravaginal defect repair, patients can expect a recovery period that may involve monitoring for any complications, such as infection or bleeding. Post-operative care typically includes pain management and instructions for activity restrictions to promote healing. Patients may be advised to avoid heavy lifting and strenuous activities for a specified duration. Follow-up appointments are essential to assess the surgical site and ensure proper healing. The overall goal of the procedure is to restore normal pelvic support and alleviate symptoms associated with pelvic organ prolapse.
| Short Descr | REPAIR PARAVAG DEFECT OPEN | Medium Descr | PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR | Long Descr | Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Hospital Part B services paid through a comprehensive APC | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 129 - Repair of cystocele and rectocele, obliteration of vaginal vault |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 52 | Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| 2008-01-01 | Changed | Code description changed. |
| 1996-01-01 | Added | First appearance in code book in 1996. |
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