# what constitutes a vulvectomy?



## jenmar (Nov 20, 2012)

Does the doctor need to take the clitoris in order to use CPT codes 56620 or 56625? Some of us think yes while others think not. Any other opions are greatly appreciated. Below is the Lay Description.
Thanks

The physician removes part or all of the vulva to treat premalignant or malignant lesions. A simple complete vulvectomy includes removal of all of the labia majora, labia minora, and clitoris, while a simple, partial vulvectomy may include removal of part or all of the labia majora and labia minora on one side and the clitoris. The physician examines the lower genital tract and the perianal skin through a colposcope. In 56620, a wide semi-elliptical incision that contains the diseased area is made. In 56625, two wide elliptical incisions encompassing the vulvar area are made. One elliptical incision extends from well above the clitoris around both labia majora to a point just in front of the anus. The second elliptical incision starts at a point between the clitoris and the opening of the urethra and is carried around both sides of the opening of the vagina. The underlying subcutaneous fatty tissue is removed along with the large portion of excised skin. Vessels are clamped and tied off with sutures or are electrocoagulated to control bleeding. The considerable defect is usually closed in layers using separately reportable plastic techniques. Vaginal gauze packing may be placed in the vagina.


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