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A conization of the cervix, also known as cervical conization, is a surgical procedure that involves the removal of a cone-shaped section of cervical tissue. This procedure can be performed with or without additional techniques such as fulguration, dilation and curettage, and repair. The conization can be executed using either a cold knife or laser, depending on the specific requirements of the case. The primary goal of this procedure is to excise abnormal cervical tissue, particularly from the transformation zone, which is the area where cervical cancer often develops. The procedure begins with the placement of a weighted speculum to provide visibility and access to the cervix. In some cases, cervical cerclage may be utilized to manage bleeding during the procedure. The cervix is then assessed for length and the position of the internal os, followed by the application of Lugol solution to enhance visualization of the cervical tissue. The excision is performed carefully to ensure that a margin of healthy tissue is preserved, which is crucial for accurate diagnosis and treatment. The use of laser technology allows for precise incisions, and bleeding can be controlled through various methods, including local vasoconstrictors or cautery. The procedure may also involve curettage to remove any remaining cervical tissue and may require suturing to repair the cervix if necessary. Overall, conization of the cervix is a critical procedure in the management of cervical abnormalities and plays a significant role in the early detection and treatment of cervical cancer.
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The conization of the cervix is indicated for several specific conditions and symptoms, which include:
The conization of the cervix involves several detailed procedural steps, which are as follows:
After the conization of the cervix, patients may experience some discomfort and should be monitored for any signs of complications, such as excessive bleeding or infection. It is important for patients to follow post-procedure care instructions provided by their healthcare provider, which may include avoiding sexual intercourse, tampons, and douching for a specified period. Follow-up appointments are typically scheduled to assess healing and to discuss the results of the excised tissue. Patients should be informed about potential symptoms to watch for, such as unusual discharge or severe pain, and advised to contact their healthcare provider if these occur.
| Short Descr | CONIZATION OF CERVIX | Medium Descr | CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER | Long Descr | Conization of cervix, with or without fulguration, with or without dilation and curettage, with or without repair; cold knife or laser | 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) | 1 - Statutory payment restriction for assistants at surgery applies to this procedure... | Co-Surgeons (62) | 0 - Co-surgeons not permitted for this procedure. | 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 | ASC Payment Indicator | Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight. | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 125 - Other excision of cervix and uterus |
| 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). | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 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 | CR | Catastrophe/disaster related | GC | This service has been performed in part by a resident under the direction of a teaching physician | SG | Ambulatory surgical center (asc) facility service | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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