CPT® Code 59100

1. Indications

The abdominal hysterotomy (CPT® Code 59100) is performed for specific medical indications, primarily related to abnormal pregnancies. The following conditions warrant this surgical intervention:

• Hydatidiform Mole - This condition involves the abnormal proliferation of placental tissue, which can lead to complications if not addressed.
• Failed Abortion - In cases where a spontaneous abortion has not been completed, an abdominal hysterotomy may be necessary to remove retained products of conception.

2. Procedure

The procedure for an abdominal hysterotomy involves several critical steps to ensure the safe removal of the abnormal tissue and to minimize complications. The following procedural steps are outlined:

• Step 1: Incision - The surgeon begins by making an incision in the lower abdomen, allowing access to the pelvic cavity. This incision is typically horizontal, similar to that used in a cesarean section, to facilitate exposure of the uterus.
• Step 2: Uterine Access - Once the abdomen is opened, the surgeon carefully exposes the uterus and enters it through the lower segment. This approach is crucial for accessing the area where the hydatidiform mole or nonviable fetus is located.
• Step 3: Removal of Tissue - The physician then removes the hydatidiform mole or the nonviable fetus along with the associated placental tissue. If the procedure is performed due to a hydatidiform mole, the surgeon inspects the uterus to ensure that all abnormal tissue has been excised completely.
• Step 4: Pathological Examination - Any tissue removed during the procedure is sent to pathology for examination, particularly important in cases of hydatidiform moles due to their potential to develop into choriocarcinoma.
• Step 5: Curettage (if necessary) - If the procedure is performed for abortion, the surgeon may perform curettage to ensure that the uterine cavity is clear of all products of conception before closing the incision.
• Step 6: Closure - Finally, the surgeon closes the abdominal incision in layers, ensuring proper alignment and suturing of the tissues to promote healing.

3. Post-Procedure

After the abdominal hysterotomy, patients are typically monitored for any signs of complications, such as infection or excessive bleeding. Recovery may involve pain management and follow-up appointments to assess healing and ensure that all abnormal tissue has been successfully removed. Patients may also receive instructions regarding activity restrictions and signs of potential complications to watch for during their recovery period.