# CPT for treatment of UTERINE INVERSION



## susan n fox (Aug 12, 2010)

Patient delivered, complications: uterine inversion.
This was treated sucessfully, without having to resort to hyserectomy.
I cannot find a CPT code for this procedure.
Thanks for any help in advance.


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## preserene (Aug 12, 2010)

59899  with the supporting Diagnosis code 665.24. No other code could be traced so far. May be it is  on the way for 2011 coding! Till then, I think we would have to assign 59899. This CPT info I got in the forum from Lisa Curtis very experienced  expert. Credit  goes to her.
 Actually it is a reposition or replacement of Acute inverted Uterus -an immediate life threatening situation which needs very immediate mangement  under GA.
I do not find a CPTcode within my reach.


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## MJ4ever (Aug 19, 2010)

Hello, 

I am wondering if 665.22 or 655.24 should be used, depending on the timeframe of the uterine inversion.

665.22 states delivered, with mention of postpartum complication (Delivered on this Admin, condition began after delivery)

665.24 states, postpartum condtion or complication (delivered before admission, outside hospital or on previous admission)

Just putting it out there.
What do you guys think?

thanks,


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## preserene (Aug 19, 2010)

From the case scenerio, we infer it was an acute inversion uterus soon after delivery, however, the place of delivery is not known. The fifth digit code could be .2  or .4 
 But it is with reference to the place of delivery not as to the duration (acute or chronic) of the inversion. All cases are acute at the start of the occurence. Our reference is to the Obstetrical, clinical- Acute or chronic inversion- is about the lapse of time after delivery. 
As regards the inversion  uterus, immediate postpartum /  late in  puerperium determines the acute or chronic inversion uterus(obstetrical).  So puerperal inversion can be chronic too if it was few days - around7days or more after delivery . 
There are cases which could  be non puerperal( non obstetrical) chronic inversion due to other reasons like myoma, sarcoma etc ( out of puerperium); they do  not present themselves in late pregnancy or Delivery, obviously.

The 5th digit assignment  I think , now I am bit more clear. do I?


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## MJ4ever (Aug 19, 2010)

For 600 series dx codes during the postpartum period, I usually add 4 as the 5th digit, but this one made me wonder because 5th digit 2 would seem to be for immediately after the delivery and 5th digit 4 seems like later on during the postpartum period. Does it makes sense what I'm trying to say? 
Anyhow, thanks for your explanation. I appreciate and learn from the different views.


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## preserene (Aug 19, 2010)

Thank you Andrade, I appreciate. You know what? I learnt something new too out of your thread. 
"665.22 states delivered, with mention of postpartum complication (Delivered on this Admin, condition began after delivery)

665.24 states, postpartum condtion or complication (delivered before admission, outside hospital''.
Yes when we rush up with the each code and its correlation with these 5th digit, we are not able to make the right sense sometimes.I felt it and used to confuse me. But you rightly gave the meaning of it and gave me more clarification to ponder more about. 
yes the .22 meant the delivery at the hospital ( that too at the labor suite; Even if it delivers at ED or at the door of the hospital, it is considered outside delivery.) .24 comes for delivered outside with providing info of post partum condition and its complication. It never occured to my mind before as it occured today.
It is understandable that the wording in .22 and .24 could lead us the way you persumed  but as it being a common factor for many codes following its notes, and the specificity  and the nature of this condition, I feel it does not make the same meaning as we persume.
Thank you Andrade, you enlightened and gave me an insight into it. 
Thank you


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