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The procedure described by CPT® Code 59320 refers to the cerclage of the cervix during pregnancy, a surgical intervention aimed at addressing an incompetent cervix. An incompetent cervix is a condition where the cervix begins to open prematurely, which can lead to complications such as miscarriage or preterm labor. This procedure is particularly indicated for women with a history of second-trimester miscarriages, those who have undergone cervical surgeries such as loop electrical excision procedures or cone biopsies, or those who have experienced other forms of cervical injury. The primary goal of cervical cerclage is to provide support to the cervix, preventing it from dilating too early and thereby reducing the risk of premature labor and delivery. Typically, this procedure is performed between 12 to 14 weeks of gestation; however, it can also be conducted as an emergency measure later in pregnancy if there are signs of cervical opening. The cerclage is placed using a vaginal approach, where the physician may employ techniques such as the McDonald-type cerclage, which involves weaving a purse-string suture around the cervix, or the Shirodkar-type procedure, which involves tunneling the suture subcutaneously around the cervix. Both methods aim to secure the cervix and maintain its closure throughout the pregnancy.
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The cerclage of the cervix during pregnancy is indicated for several specific conditions and circumstances that may compromise the integrity of the cervix. These indications include:
The procedure for cervical cerclage involves several key steps to ensure the effective placement of the suture around the cervix. The following procedural steps are typically followed:
After the cervical cerclage procedure, patients are typically advised to rest and avoid strenuous activities to minimize the risk of complications. Monitoring for any signs of infection, bleeding, or premature labor is crucial. Follow-up appointments are scheduled to assess the condition of the cervix and the effectiveness of the cerclage throughout the remainder of the pregnancy. Patients may also receive guidance on managing any discomfort and understanding the signs that would require immediate medical attention.
| Short Descr | REVISION OF CERVIX | Medium Descr | CERCLAGE CERVIX PREGNANCY VAGINAL | Long Descr | Cerclage of cervix, during pregnancy; vaginal | Status Code | Active Code | Global Days | 000 - Endoscopic or 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) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 141 - Other therapeutic obstetrical procedures |
| 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). | AG | Primary physician | 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 |
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| 1990-01-01 | Added | First appearance in code book in 1990. |
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