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The procedure described by CPT® Code 57545 involves the excision of the cervical stump through an abdominal approach, accompanied by a pelvic floor repair. This surgical intervention is typically indicated for patients who have previously undergone a subtotal abdominal hysterectomy and are now facing complications such as cervical neoplasm or myoma. The term "cervical stump" refers to the remaining portion of the cervix that may persist after a hysterectomy. The excision aims to remove this stump to address any pathological conditions while also ensuring the integrity of the pelvic floor through repair techniques. The procedure requires careful dissection and manipulation of surrounding structures, including the bladder and ligaments, to safely remove the cervical stump while minimizing potential complications. The abdominal approach allows for direct access to the pelvic organs, facilitating the excision and subsequent repair of the pelvic floor structures.
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The excision of the cervical stump via an abdominal approach with pelvic floor repair is indicated for specific conditions that may arise following a subtotal abdominal hysterectomy. These indications include:
The procedure for excising the cervical stump begins with the physician making an incision in the lower abdomen, which is carefully extended down to the rectus abdominis muscles. These muscles are separated along the midline to provide access to the peritoneal cavity. Once the peritoneum is elevated and opened, the round ligaments are identified, elevated, and ligated with sutures to prevent excessive bleeding during the procedure.
After the excision of the cervical stump and pelvic floor repair, patients can expect a recovery period that may involve monitoring for any signs of complications such as infection or excessive bleeding. Post-operative care typically includes pain management, instructions for activity restrictions, and follow-up appointments to assess healing. Patients may also be advised on pelvic floor exercises to support recovery and maintain pelvic health. It is essential for healthcare providers to provide clear guidance on signs of complications that should prompt immediate medical attention.
| Short Descr | REMOVE CERVIX/REPAIR PELVIS | Medium Descr | EXC CERVICAL STUMP ABDL APPR W/PELVIC FLOOR RPR | Long Descr | Excision of cervical stump, abdominal approach; with pelvic floor repair | 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) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 125 - Other excision of cervix and uterus |
| 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| Pre-1990 | Added | Code added. |
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