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Postpartum curettage, as defined by CPT® Code 59160, is a surgical procedure performed to remove tissue from the uterus following childbirth. This procedure is typically indicated when there is a need to clear the uterine cavity of retained products of conception, which may occur after a delivery. The process begins with the insertion of a speculum into the vagina to allow for visualization and access to the cervix. The cervix is then carefully cleansed with an antiseptic solution to minimize the risk of infection. A tenaculum, a surgical instrument used to grasp tissue, is applied to the anterior cervical lip to stabilize the cervix during the procedure. A uterine sound is then introduced to assess the depth and angle of the uterus, ensuring that the curettage is performed safely and effectively. Following this, a curette, which is a surgical instrument designed for scraping, is inserted through the cervix to either scrape or suction the uterine wall, thereby removing any remaining tissue. The excised tissue is typically sent for pathological examination to check for any abnormalities. After the procedure, the tenaculum is removed, and any bleeding from the cervix is managed through the application of pressure, ensuring patient safety and comfort during the recovery process.
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The procedure of postpartum curettage is indicated in specific clinical scenarios following childbirth. These indications include:
The procedure of postpartum curettage involves several critical steps to ensure its effectiveness and safety. The first step is the insertion of a speculum into the vagina, which allows the healthcare provider to visualize the cervix clearly. Following this, the cervix is cleansed with an antiseptic solution to reduce the risk of infection during the procedure. The anterior cervical lip is then grasped using a tenaculum, a specialized instrument that helps stabilize the cervix and provides better access to the uterine cavity. Once the cervix is secured, a uterine sound is passed through the cervix to measure the depth and angle of the uterus, which is essential for guiding the subsequent steps of the procedure. After confirming the uterine dimensions, a curette is carefully inserted through the cervix. The curette is used to scrape or suction the uterine wall, effectively removing any retained tissue. This tissue is then collected and sent for pathological examination to assess for any abnormalities. Once the curettage is complete, the tenaculum is removed, and any bleeding from the cervix is controlled by applying pressure to ensure hemostasis and promote patient safety.
After the completion of postpartum curettage, patients are typically monitored for any signs of complications, such as excessive bleeding or infection. It is important for healthcare providers to ensure that the patient is stable and that any bleeding is adequately controlled. Patients may be advised to rest and avoid strenuous activities for a short period following the procedure. Additionally, they may receive instructions regarding signs of potential complications to watch for, such as fever, severe abdominal pain, or heavy bleeding, which would require immediate medical attention. Follow-up appointments may be scheduled to assess recovery and discuss the results of the pathological examination of the tissue that was removed during the procedure.
| Short Descr | D & C AFTER DELIVERY | Medium Descr | CURETTAGE POSTPARTUM | Long Descr | Curettage, postpartum | Status Code | Active Code | Global Days | 010 - Minor Procedure | 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) | 0 - Payment restriction for assistants at surgery applies 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) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 127 - Dilatation and curettage (D&C), aspiration after delivery or abortion |
| 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). | 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.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | XE | Separate encounter, a service that is distinct because it occurred during a separate encounter |
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