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The procedure described by CPT® Code 59871 involves the removal of a cervical cerclage suture under anesthesia that is not local. A cervical cerclage is a stitch placed around the cervix to support it during pregnancy, particularly in cases where there is a risk of premature birth due to cervical insufficiency. The removal of this suture is typically performed under regional or general anesthesia, which may be necessary due to various clinical circumstances. This procedure can occur either before the onset of labor or after the global period associated with the placement of the cerclage. In standard practice, if a patient is expected to deliver vaginally, the cerclage is usually removed around 36 to 37 weeks of gestation, often in an office setting with local anesthesia. However, for patients scheduled for a cesarean delivery, the cerclage is generally removed during the cesarean procedure itself. In cases where complications arise, particularly when the cerclage has been placed through an abdominal incision, the removal may need to be conducted under regional or general anesthesia at a different time than the delivery. The surgical technique for removing a transabdominally placed cerclage involves making an incision in the lower abdomen, followed by careful dissection to reach the cervix, where the cerclage sutures are then exposed and removed.
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The removal of a cervical cerclage suture under anesthesia is indicated in specific clinical scenarios, particularly when the following conditions are present:
The procedure for the removal of a cervical cerclage suture under anesthesia involves several critical steps, which are outlined as follows:
Post-procedure care following the removal of a cervical cerclage suture under anesthesia includes monitoring the patient for any immediate complications related to the surgery. Patients may experience some discomfort or cramping following the procedure, which can be managed with appropriate pain relief. It is essential to provide instructions regarding activity restrictions and signs of potential complications, such as excessive bleeding or signs of infection. Follow-up appointments may be scheduled to ensure proper healing and to monitor the patient's recovery, especially if the removal was performed due to complications.
| Short Descr | REMOVE CERCLAGE SUTURE | Medium Descr | REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA | Long Descr | Removal of cerclage suture under anesthesia (other than local) | 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 | T-Packaged Codes | 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 | 131 - Other non-OR therapeutic procedures, female organs |
| 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). | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | AG | Primary physician | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 1998-01-01 | Added | First appearance in code book in 1998. |
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