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Transposition of the ovaries is a surgical procedure aimed at relocating the ovaries to a position that minimizes their exposure to radiation during cancer treatment. This procedure is particularly relevant for women of child-bearing age who are diagnosed with malignant neoplasms affecting gynecological structures or other cancers, such as colorectal cancer or Hodgkin's lymphoma. The primary goal of ovarian transposition is to preserve fertility by protecting the ovaries from the damaging effects of radiation therapy, which can lead to infertility or other reproductive issues. During the procedure, a surgical incision is made in the abdomen, allowing access to the ovaries. The surgical team carefully dissects the surrounding tissues to identify and protect the ovarian vessels and ureters, ensuring that the blood supply to the ovaries remains intact. The ovaries are then repositioned to a higher location in the abdominal cavity, specifically in the paracolic gutters, which are areas adjacent to the colon. This strategic placement is crucial as it places the ovaries outside the radiation treatment fields, thereby safeguarding their function and increasing the likelihood of preserving the patient's fertility post-treatment. Marking the ovaries with hemoclips further aids in their identification during follow-up imaging, ensuring that they remain outside the radiation portals throughout the course of therapy.
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Transposition of the ovaries is indicated for women of child-bearing age who are undergoing radiation therapy for various malignancies. The specific indications for this procedure include:
The procedure for ovarian transposition involves several critical steps to ensure the successful relocation of the ovaries while maintaining their blood supply. The steps are as follows:
After the transposition of the ovaries, patients may require monitoring for any immediate post-operative complications. Expected recovery includes managing any discomfort from the surgical incision and ensuring proper healing. Patients are typically advised to follow up with their healthcare provider for imaging studies to confirm the position of the ovaries and to discuss any further treatment plans related to their cancer therapy. It is essential to ensure that the ovaries remain outside the radiation fields throughout the course of treatment to maximize the chances of preserving fertility.
| Short Descr | TRANSPOSITION OVARY(S) | Medium Descr | TRANSPOSITION OVARY | Long Descr | Transposition, 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) | 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 | 120 - Other operations on ovary |
| 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. | XS | Separate structure, a service that is distinct because it was performed on a separate organ/structure |
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| 2011-01-01 | Changed | Short description changed. |
| Pre-1990 | Added | Code added. |
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