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A trachelorrhaphy, also known as a plastic repair of the uterine cervix, is a surgical procedure that aims to repair lacerations or injuries to the cervix, which is the lower part of the uterus that opens into the vagina. This procedure is performed through a vaginal approach, allowing direct access to the cervix. During the operation, the surgeon first exposes the cervix and carefully identifies the location and extent of the laceration. To ensure patient comfort and minimize pain during the procedure, the cervix is cleansed and infiltrated with a local anesthetic. The repair process begins with the placement of the first suture above the apex of the cervical laceration, which is crucial for controlling any bleeding that may occur. Following this initial step, sutures are meticulously placed along the entire length of the laceration to ensure proper closure and healing. This procedure is essential for restoring the integrity of the cervix and can be indicated in various clinical scenarios where cervical lacerations are present.
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The trachelorrhaphy procedure is indicated for specific conditions related to the cervical area. These indications include:
The trachelorrhaphy procedure involves several critical steps to ensure effective repair of the cervical laceration. The following procedural steps are performed:
After the trachelorrhaphy procedure, patients may require specific post-operative care to ensure proper healing and recovery. It is important to monitor for any signs of complications, such as excessive bleeding or infection. Patients are typically advised to avoid strenuous activities and sexual intercourse for a specified period to allow the cervix to heal adequately. Follow-up appointments may be scheduled to assess the healing process and address any concerns that may arise during recovery.
| Short Descr | REVISION OF CERVIX | Medium Descr | TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG | Long Descr | Trachelorrhaphy, plastic repair of uterine cervix, 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) | 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 | 132 - Other OR therapeutic procedures, female organs |
| 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. | 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.) | 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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| Pre-1990 | Added | Code added. |
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