# Vaginal Cuff Granulation Tissue



## kellyg (Mar 12, 2013)

Procedure: Removal of granulation tissue and Ethibond suture from the vaginal cuff bilaterally and oversewing of this area after cauterization.

The granulation tissue was removed with forceps and in the process of removing this the suture material was uncovered bilaterally. This was cut and removed and further granulation tissue removed. The areas were then cauterized with silver nitrate. The area of both cuffs was then oversewn.

CPT suggestions please!


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## kvangoor (Mar 12, 2013)

15850?


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## Thouvenel (Mar 12, 2013)

Is this a re-opening or done vaginally?  What about 57415?


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## kellyg (Mar 19, 2013)

The op note states the patient was taken to the OR where she was given general anesthetic and then placed in the lithotomy position. She was prepped and draped in the usual manner and a surgical pause was performed.  The granulation tissue was removed with forceps; and in the process of removing this, the suture material was uncovered bilaterally.  This was cut and removed and further granulation tissue removed.  When no more granulation tissue was visible or could be removed, these areas were cauterized with silver nitrate.  The area of both cuffs was then oversewn with vaginal mucosa with 4-0 chromic.

I would hesitate to use 57135 as no vaginal cyst or tumor is being removed.


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## Thouvenel (Mar 19, 2013)

57415 is removal of impacted vaginal foreign body under anesthesia.  I don't know if you can consider the sutures impacted but they are foreign bodies


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