Endoloop ligation of umbilical cord from retained placenta of Twin A

valerieeanderson

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Buckeye, AZ
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I need help with coding the following procedure. My coder is suggesting an unlisted CPT and compare to CPT 59072. The H&P indicates patient did not know she was pregnant and delivered one fetus at home which was stillborn, pt then presents to hospital via ambulance for the following procedure. Any assistance and/or resources is greatly appreciated.

IP_Date of Procedure: 4/22/22

Preprocedural Diagnosis:
s/p previable SVD @ 20 wks with remaining live twin gestation, desires delayed interval delivery
Post procedure Diagnosis:
same, purulent discharge at level of cervix

Procedure:
Endoloop ligation of umbilical cord from retained placenta of Twin A

Findings:
10 cm dangling cord with plastic clasp tracking up and to the R side, multiparous cervix ~ 3 cm dilated, no active bleeding from cervix but purulent discharge appreciated at the external os, aerobic culture and GCCT swabs collected

Procedure
In patient room, bed was broken down and patient legs placed into leg rests. Sterile speculum placed with careful guidance around the cord, using forceps to ensure it was not caught within the speculum blades or between speculum and vaginal walls. 0-vicryl Endoloop passed around the clasp and cord then pushed up as far as able, flush against the cervix. Endoloop closed down around the cord here and suture trimmed ~ 1 cm. ~9 cm length of cord removed. Cultures collected as above given this provided improved visualization. The patient tolerated the procedure well.
 
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