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The procedure described by CPT® Code 57555 involves the excision of the cervical stump through a vaginal approach, accompanied by anterior and/or posterior repair. This surgical intervention is typically indicated for patients who have previously undergone a sub-total hysterectomy and later develop cervical malignancy. The excision process begins with the placement of a tenaculum on the cervix, which aids in stabilizing the cervix during the procedure. An incision is made in the upper aspect of the vaginal mucosa surrounding the cervical stump, allowing for the careful dissection and separation of the bladder from the cervix, as well as the lysis of any adhesions present. The cervical stump, along with surrounding parametrial tissue and a portion of the vagina, is excised and sent for frozen section analysis to assess for malignancy. Following the excision, the procedure continues with the anterior and/or posterior repair, which involves meticulous dissection and suturing techniques to ensure proper anatomical restoration and function. This comprehensive approach not only addresses the malignancy but also aims to restore the structural integrity of the vaginal and pelvic support systems.
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The procedure is indicated for patients who have had a previous sub-total hysterectomy and subsequently develop malignancy of the cervix. This condition necessitates the excision of the cervical stump to address the malignancy effectively.
The procedure begins with the placement of a tenaculum on the cervix to stabilize it. An incision is made in the upper aspect of the vaginal mucosa around the entire cervical stump. This incision allows for the application of tension on the tenaculum, facilitating sharp and blunt dissection to free the bladder from the cervix and to lyse any adhesions that may be present. Once the cervical stump is adequately mobilized, it is excised along with parametrial tissue and a portion of the vagina, which is then sent for frozen section analysis to evaluate for malignancy.
Post-procedure care involves monitoring for any complications such as bleeding or infection. Patients may experience discomfort and will require pain management. Follow-up appointments are essential to assess healing and to ensure that there are no signs of malignancy recurrence. Patients should be advised on activity restrictions and signs of complications that warrant immediate medical attention.
| Short Descr | REMOVE CERVIX/REPAIR VAGINA | Medium Descr | EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR | Long Descr | Excision of cervical stump, vaginal approach; with anterior and/or posterior 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 | 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 |
| 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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| 2013-01-01 | Changed | Medium Descriptor changed. |
| Pre-1990 | Added | Code added. |
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