# cul-de-sac lesion



## Jamie Dezenzo (Dec 2, 2011)

Hi all,

Doctor started out doing 58563 and 58671 then at the end scope was removed 

"Attention was then returned to the posterior cul-de-sac. The Vulsellum tenaculum was removed. Hemostasis was adequate. The bivalve speculum was used to isolate the lesion in the posterior cul-de-sac. This was removed with a stone forceps and passed off to pathology. The area was then cauterized with silver nitrate. A suture of 2-0 chromic was then used in a figure-of-eight fashion to completely achieve hemostasis."

Path came back cul-de-sac endometriosis

I'm having a hard time finding a CPT...usually done w/ scope.

Thanks!


----------



## ajs (Dec 2, 2011)

Jamie Dezenzo said:


> Hi all,
> 
> Doctor started out doing 58563 and 58671 then at the end scope was removed
> 
> ...



Try 57135 excision of vaginal cyst or tumor.  It is the closest thing I could find and the description of the procedure matches.


----------



## Jamie Dezenzo (Dec 2, 2011)

yes, I did look at that code....cul de sac part of the pelvic peritoneum but the approach was through the vagina.....maybe 58999 compare 57135?


----------



## ajs (Dec 2, 2011)

Jamie Dezenzo said:


> yes, I did look at that code....cul de sac part of the pelvic peritoneum but the approach was through the vagina.....maybe 58999 compare 57135?



The cul de sac is closest to the deepest part of the vagina that ends up behind the cervix.  Since the procedure was accomplished vaginally and the area is at the furthermost end of the posterior vaginal fornix, I still think the closest procedure code is 57135.  You can certainly use the unlisted code and go for it that way if you choose.


----------



## Jamie Dezenzo (Dec 5, 2011)

thanks for your help!!!


----------

