CPT® Code 59830

1. Indications

The procedure described by CPT® Code 59830 is indicated for the treatment of septic abortion, which may arise under the following conditions:

• Fetal Demise The fetus has died in utero, leading to potential complications.
• Uterine Infection The mother develops an infection of the uterus or uterine contents, which can occur before, during, or after the abortion.
• Retained Products of Conception There may be retained tissue that requires surgical intervention to prevent further complications.

2. Procedure

The surgical treatment for septic abortion involves several critical steps to ensure the effective removal of infected tissue and any retained products of conception:

• Step 1: Preparation The procedure begins with the placement of a speculum in the vagina to allow for visualization of the cervix. The cervix is then exposed and cleansed with an antiseptic solution to reduce the risk of further infection.
• Step 2: Cervical Manipulation The anterior cervical lip is grasped with a tenaculum, a surgical instrument that helps stabilize the cervix during the procedure. This step is crucial for ensuring access to the uterine cavity.
• Step 3: Dilation The cervix is numbed and dilated using a series of metal rods of increasing diameter, which are carefully passed into the cervical canal. This dilation is necessary to allow the suction curette to be inserted into the uterus.
• Step 4: Suction Curettage A suction curette is then inserted through the cervix, and suction is initiated. The curette is rotated in a full circle several times to effectively remove the uterine contents. The procedure continues until tissue and blood stop passing through the curette, indicating that the suction evacuation is complete.
• Step 5: Sharp Curettage (if necessary) In some cases, it may be necessary to follow the suction curettage with sharp curettage, which involves scraping the uterine lining to ensure that all products of conception have been removed. This step is critical to prevent complications such as infection or hemorrhage.
• Step 6: Pathology Examination The tissue that has been removed is sent for pathology examination to assess for any abnormalities or further complications.
• Step 7: Post-Procedure Care After the procedure, the tenaculum is removed, and any bleeding from the cervix is controlled with pressure. The patient is then placed on intravenous or oral antibiotic therapy to manage the infection and promote recovery.

3. Post-Procedure

Following the surgical treatment of septic abortion, patients are closely monitored for any signs of complications. They are typically placed on a course of intravenous or oral antibiotics to combat the infection and prevent recurrence. Recovery may vary depending on the individual, but patients are advised to follow up with their healthcare provider to ensure proper healing and to address any concerns that may arise during the recovery period. It is essential for patients to report any unusual symptoms, such as excessive bleeding or signs of ongoing infection, to their healthcare provider promptly.