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The CPT® Code 57550 refers to the excision of the cervical stump through a vaginal approach. This procedure is specifically indicated for patients who have previously undergone a sub-total hysterectomy and later develop cervical malignancy. During the excision, a tenaculum is utilized to grasp the cervix, allowing the physician to make an incision in the upper part of the vaginal mucosa that encircles the cervical stump. The procedure involves applying tension to the tenaculum, followed by both sharp and blunt dissection techniques to separate the bladder from the cervix and to break down any adhesions present. The excised cervical stump is removed along with surrounding parametrial tissue and a segment of the vagina, which is then sent for frozen section analysis to assess for malignancy. This procedure is critical in managing cervical cancer in patients with a history of hysterectomy, ensuring that any malignant tissue is effectively removed while preserving surrounding structures as much as possible.
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The excision of the cervical stump via a vaginal approach is indicated for patients who have undergone a sub-total hysterectomy and subsequently develop malignancy of the cervix. This procedure is essential for addressing the presence of cancerous tissue in the cervical stump that remains after the hysterectomy.
The procedure begins with the placement of a tenaculum on the cervix to provide traction. This allows the physician to make a circumferential incision in the upper aspect of the vaginal mucosa surrounding the cervical stump. Following the incision, tension is applied to the tenaculum, and the physician employs both sharp and blunt dissection techniques to carefully separate the bladder from the cervix and to lyse any adhesions that may be present. Once the surrounding structures are adequately freed, the cervical stump is excised along with adjacent parametrial tissue and a portion of the vagina. This excised tissue is then sent for frozen section analysis to determine the presence of malignancy.
Post-procedure care involves monitoring the patient for any complications that may arise from the excision. Patients may experience some discomfort and should be advised on pain management strategies. Follow-up appointments are essential to assess healing and to review the results of the frozen section analysis. Any additional treatments or interventions may be determined based on the findings from the excised tissue. It is also important to provide guidance on activity restrictions during the recovery period to ensure proper healing.
| Short Descr | REMOVAL OF RESIDUAL CERVIX | Medium Descr | EXCISION CERVICAL STUMP VAGINAL APPROACH | Long Descr | Excision of cervical stump, vaginal 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) | 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 | 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 125 - Other excision of cervix and uterus |
| 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). | 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 |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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