Karen A.
Guest
Any thoughts besides an unlisted code for this surgery? Anterior/posterior colporrhapy with enterocle repair (57265) and vaginal colpopexy-(sacrospinous) 57282 was done 2 months ago. Medicare patien, is still in global period. Patient was doing fine at 2 post op appointments. Last week, pt was in the ER w/pain. Preop and post op dx were severve sciatic pain, possibly resulting from previous pelvic surgery & retention of stool secondary to hydrocodone that was taken for pain.
Procedure done: sacrospinous fixation takedown with removal of sacrospinous ligament suture, Gore-tex. Episiotomy with repair.
A relaxing excision with an episiotomy was done for better visualiziation. Vaginal cuff incised with a knife, "We then opened up the space to the ischiorectal fossa and ..traced steps back to the sacropinious ligament. ..was able to feel and visualize both sutures. They were cut using scissors and the knots were removed. ...there was no evidence of suture present on the sacrospinious ligament fixation. ...the vaginal cuff was reapproximated ....reapproximated the episiotomy.... the procedure took 1 1/2 hours.
I've never encountered this situation, and am hoping to hear from someone who has.
thanks
Procedure done: sacrospinous fixation takedown with removal of sacrospinous ligament suture, Gore-tex. Episiotomy with repair.
A relaxing excision with an episiotomy was done for better visualiziation. Vaginal cuff incised with a knife, "We then opened up the space to the ischiorectal fossa and ..traced steps back to the sacropinious ligament. ..was able to feel and visualize both sutures. They were cut using scissors and the knots were removed. ...there was no evidence of suture present on the sacrospinious ligament fixation. ...the vaginal cuff was reapproximated ....reapproximated the episiotomy.... the procedure took 1 1/2 hours.
I've never encountered this situation, and am hoping to hear from someone who has.
thanks