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The CPT® Code 59140 refers to the surgical treatment of a cervical ectopic pregnancy through evacuation. A cervical ectopic pregnancy occurs when a fertilized ovum implants within the cervical stricture, specifically below the internal os. This abnormal implantation leads to the growth of the trophoblast, which invades the endocervix, resulting in the pregnancy developing within the fibrous cervical canal. Patients with this condition often present with symptoms such as vaginal bleeding, which can be a significant concern due to the potential for life-threatening hemorrhage. In many cases, conservative treatment options are limited, and a hysterectomy may be necessary to manage the situation effectively. However, when conservative management is feasible, it typically involves a combination of systemic chemotherapy and cervical evacuation, which may include curettage. The initial treatment may consist of administering multiple doses of methotrexate and leucovorin over a four-day period. If complications arise, such as hemorrhage, ligation of the cervical arteries may be performed to control bleeding. The evacuation of the products of conception from the cervical canal can be achieved through sharp curettage or suction curettage. To manage bleeding, techniques such as cervical tamponade using a balloon catheter or cervical stay sutures may be employed. Additionally, local injections of vasoconstrictors and cervical cerclage may be utilized, followed by cervical curettage and evacuation to ensure the safety and health of the patient.
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The surgical treatment of cervical ectopic pregnancy, as indicated by CPT® Code 59140, is performed under specific circumstances where the following conditions are present:
The procedure for the surgical treatment of cervical ectopic pregnancy involves several critical steps, which are outlined as follows:
After the surgical treatment of cervical ectopic pregnancy, patients are monitored for any signs of complications, including excessive bleeding or infection. Recovery may involve follow-up appointments to ensure that the cervix is healing properly and that there are no residual products of conception. Patients may also receive guidance on future pregnancies and any necessary reproductive health considerations. It is essential for healthcare providers to provide thorough post-operative care and support to facilitate the patient's recovery and address any emotional or psychological impacts following the procedure.
| Short Descr | TREAT ECTOPIC PREGNANCY | Medium Descr | TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION | Long Descr | Surgical treatment of ectopic pregnancy; cervical, with evacuation | 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 | 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 | 122 - Removal of ectopic pregnancy |
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| Pre-1990 | Added | Code added. |
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