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Laparoscopic supracervical hysterectomy (LSH) is a minimally invasive surgical procedure designed to remove the uterus while preserving the cervix and its associated structures. This approach serves as an alternative to the more traditional total abdominal hysterectomy, offering several advantages, including reduced recovery time and less postoperative pain. By maintaining the cervix and its secretory glands, LSH helps to preserve pelvic support and sexual function, which can be significant considerations for many patients. It is important to note that LSH is not indicated for patients with a diagnosis of cancer or those who have a history of precancerous cervical pathology, as these conditions may necessitate a more extensive surgical approach. The procedure involves the use of laparoscopic instruments, which are inserted through small incisions in the abdomen, allowing for a clear view and precise manipulation of the uterus. The technique includes the use of a retractor placed vaginally to facilitate visualization and access to the uterus, ensuring that the procedure is performed safely and effectively.
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The laparoscopic supracervical hysterectomy (LSH) is indicated for patients who meet specific criteria, primarily related to the size of the uterus and the absence of certain medical conditions. The following indications are explicitly provided:
The laparoscopic supracervical hysterectomy involves several key procedural steps that are performed with precision to ensure patient safety and optimal outcomes. The following steps outline the procedure:
After the laparoscopic supracervical hysterectomy, patients can expect a recovery period that typically involves monitoring for any complications, managing pain, and following specific postoperative care instructions. Patients are usually advised to rest and gradually increase their activity level as tolerated. Follow-up appointments are essential to assess healing and address any concerns. It is important for patients to be aware of signs of complications, such as excessive bleeding or signs of infection, and to contact their healthcare provider if these occur. Overall, the minimally invasive nature of LSH generally allows for a quicker recovery compared to traditional hysterectomy methods.
| Short Descr | LSH W/T/O UTERUS ABOVE 250 G | Medium Descr | LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY | Long Descr | Laparoscopy, surgical, supracervical hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s) | 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) | 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met. | 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 | Non office-based surgical procedure added in CY 2008 or later; 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 | 124 - Hysterectomy, abdominal and vaginal |
This is a primary code that can be used with these additional add-on codes.
| 49327 | Addon Code MPFS Status: Active Code APC N ASC N1 Laparoscopy, surgical; with placement of interstitial device(s) for radiation therapy guidance (eg, fiducial markers, dosimeter), intra-abdominal, intrapelvic, and/or retroperitoneum, including imaging guidance, if performed, single or multiple (List separately in addition to code for primary procedure) |
| 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). | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code 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 | 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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| 2007-01-01 | Added | First appearance in code book in 2007. |
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