# Uterine Inversion or Replacement



## tmyerscpc (Apr 15, 2010)

Can someone please help me??
I am trying to find a CPT code for Transvaginal Uterine Inversion or Replacement............H-E-L-P!!!!!!!!!

Thanks!


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## Lisa Bledsoe (Aug 2, 2010)

Did you ever find a code?  All I am coming up with is 59899.  Mom's uterus became inverted due to retained placenta and doc had to take her to OR to "put it back in" but there was no incision...


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## preserene (Aug 2, 2010)

I know, such a life threatening  Postpartum emergency needing so much of maneure to do a reposition of an inverted uterus under GA; and if it fails manually, then will have to go for a surgery and if the placenta still does not get separated and not able to remove (as in adherent placenta accreta/ increta percreta then will have to go for Hysterectomy and then we have a code for hysterctomy!!.) Even the 3rd stage complications like manual removal of placenta under anesthesia and so ondo not have a procedural code.Well, we have no other choice but for 59899!
It is a life threatening immediate emergency procedure, if not taken care of in time, we may loose the mother. the physician under GA repositions the uterus through a dilated cervix (with removal of partially adherent or adherent placenta)-most often  this condition has such an associated complication along with it; an adherent placenta and the procedure is quite a life saving challenge to the physician  some times will have to compromise the uterus.

well, can we give a post-partum care  code like *59430* as a separate procedure in such circumstances- with *modifier -22 *(along with other due codes for the delivery).

*with Diagnostic code 665.24 appended to it.* and a special report. I need your suggestion please !!! I feel sad there is no code for the procedure of reposition for Inversion Uterus!!

By the way, was it an Inversion Uterus following  delivery (post partum) or a delayed ,chronic any time after puerperium?!-This one, always warrants definite surgical procedure with dilation and some times may need incision of the  cervix or a major surgery on uterus.


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## Lisa Bledsoe (Aug 3, 2010)

This one was inverted after delivery due to adherent placenta.  We are going to bill 59899 and likening the fee to 59350 (hysterorrhaphy of ruptured uterus).  Seems like it should be more, but there is nothing else to choose from as far as I can tell.


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## preserene (Aug 3, 2010)

Now I understand there was difficulty in removing the placenta, while manual removal of placenta and reposition of uterus and needed to go for-rraphy. 
Well do you append modifier for this like -59 or -22 and the ICD-9CM code for inversion for support?
Thank you


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## Lisa Bledsoe (Aug 3, 2010)

665.24 is the ICD-9 and we are not appending any modifier that I am aware of.  It will be difficult enough to get payment on an unlisted code; adding a modifier could be the kiss of death!


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