I am looking for some help with our providers now using a handyvac for suction curette in the office for missed abortions. Is anyone familiar with this? I am not sure what to use for a CPT code. This is the procedure:
In office suction curettage: We discussed the procedure itself, and the risks, benefits, and alternatives, including the risk of infection, bleeding, injury to organs including uterine perforation, injury to the bladder, bowels, blood vessels, nerves. We discussed the possibility of need for further surgery. The patient had an opportunity to have all of her questions answered and informed consent was obtained.
An examination was performed demonstrating a mobile anteverted uterus with no adnexal masses appreciated. Next the patient was placed in a dorsal supine position in stirrups. A sterile speculum was placed in the vagina and the vagina and cervix were prepped with Betadine. A tenaculum was placed on the anterior lip of the cervix. Next a paracervical block was placed at 4 and 8:00 with a total of 10 cc of 1% lidocaine local anesthetic. An os finder was used to pass through the cervix. The cervix seemed to be dilated easily. Next the Handi Vac curette, flexible, is passed through the cervix into the uterine cavity which sounds to around 8 cm. Next suction was applied and a gentle up and down 360° motion continued until a gritty texture was noted. Blood and what appeared to be tissue was noted to pass into the Handi Vac. One further pass was made with no further tissue or blood noted and a gritty texture noted. The Handi Vac was removed. The tenaculum was removed. Tenaculum sites were noted to be hemostatic. There was no active bleeding noted. All instruments had been removed the patient's vagina. EBL is approximately 50 cc. The patient tolerated procedure well. She is able to ambulate after the procedure without difficulty. Discharge instructions are given.
Thank you!
In office suction curettage: We discussed the procedure itself, and the risks, benefits, and alternatives, including the risk of infection, bleeding, injury to organs including uterine perforation, injury to the bladder, bowels, blood vessels, nerves. We discussed the possibility of need for further surgery. The patient had an opportunity to have all of her questions answered and informed consent was obtained.
An examination was performed demonstrating a mobile anteverted uterus with no adnexal masses appreciated. Next the patient was placed in a dorsal supine position in stirrups. A sterile speculum was placed in the vagina and the vagina and cervix were prepped with Betadine. A tenaculum was placed on the anterior lip of the cervix. Next a paracervical block was placed at 4 and 8:00 with a total of 10 cc of 1% lidocaine local anesthetic. An os finder was used to pass through the cervix. The cervix seemed to be dilated easily. Next the Handi Vac curette, flexible, is passed through the cervix into the uterine cavity which sounds to around 8 cm. Next suction was applied and a gentle up and down 360° motion continued until a gritty texture was noted. Blood and what appeared to be tissue was noted to pass into the Handi Vac. One further pass was made with no further tissue or blood noted and a gritty texture noted. The Handi Vac was removed. The tenaculum was removed. Tenaculum sites were noted to be hemostatic. There was no active bleeding noted. All instruments had been removed the patient's vagina. EBL is approximately 50 cc. The patient tolerated procedure well. She is able to ambulate after the procedure without difficulty. Discharge instructions are given.
Thank you!
