You misunderstand me. There is a high likelihood that you are 100% correct, and the procedure happened precisely as you described it, for the specified reasons. The problem here, is that none of that is documented. To draw a simple and reasonable conclusion about the circumstances of an encounter is often necessary. You have gone quite a bit further here. Perhaps it is your vast knowledge and experience that is driving your hubris, and allowed you to, in essence, think for the doctor - describing conditions that aren't necessarily mentioned, and defining procedure details that have not been specified, no matter how much improvisation is required, on your part.Hi brandi,
You have mistaken my whole concept.
I am not imagning the scenario but analyzing the scenario.
POST VAGINAL HYSTERECTOMY, MEANING, ‘THERE IS NO CERVICAL STUMP LEFT BEHIND’ As for vaginal hysterectomy, there is no procedure of removing the body of the uterus leaving the cervix in position. We do remove Cervix and body of the uterus enmass. To get to know this, do we need this treating doctor to write down the procedure of (status) vaginal hysterectomy?
The actual procedure of vaginal hysterectomy is in finger tips with me because I have done thousands of vaginal hysterectomy. CERVICAL STUMP means the cervix without body of the uterus left behind a procedural plan; ie when doing subtotal hysterectomy . That remaining portion of the cervix is called CX STUMP. The doctor very well knows it and they document even after just a pelvic/bimanual examination. If it was what she felt was a stump she would have documented definitely as “CX STUMP”.
What she meant cuff here, means vaginal cuff ie vaginal tissues. That is the cuff or portion of vagina or the tissues of vagina I am talking about. I am aware of what is vaginal cuff.(Cuff of vagina means a portion or part or core or tissues of vagina. For eg, when they do abdominal hysterectomy if they intend to remove vaginal tissues along with, they say ‘’come on let us remove a cuff of vagina too!”).
Any one would know what the structure is, there now after vaginal/abdominal hysterectomy. Let us not go into the fundamentals which should be clear by now.
Next: colporrhaphy means repair of the “colpos” meaning “Vagina”- vaginal repair. I know the whole steps of the procedure and what is being done. Usually there will not be any redundant part left because it is clearly visualized just in front of us and trim the edges and suture it approximately. But now with mesh placement some remnants of the marginal tissues of the vagina are possible to remain as such (if not as granuloma) . this is what is meant as remnants or redundant tissues of the vagina. That cuff of vagina jutting as redundant tissues needs to be removed when it bothers .
Next: The pervious diagnosis we do not know but the doctor knows. It could be for eg, any neoplasm of the cx or uterus or even intraepithelial noeplasia. So at this age of 53, with the unknown previous diagnosis and a core of vaginal tissues ,a cuff of vaginal tissues or a mass of tissues cannot be named otherwise until the path report comes and the doctor names it . That is not the issue here. I did not mean to wait for the path report to assign a CPT code NOW
The issue is to which code to assign now. I gave my opinion of assigning a code with a number which I still stand for it
Now, the tissues or tags that is the remnants So I gave my opinion of assignment.
Next I would like to make it understandable to you- that my appearance often in the forum is to gather knowledge and to extend my knowledge& experience with my vast 30 years OBGYN specialist withM.D. & medical knowledge in a most BENIFICIAL, USABLE PRACTICAL AND CLINICAL WAY, but NOT FOR ARGUMENT OR AUDITING PURPOSE. You audit it audit.
But please do not cross or use the facts of medicine to make it obsolete for your auditing purpose. Some of you have mistakenly painted me dark.
Then, medical facts are facts; procedures are procedures; techniques are techniques; critical thinking and analyzing those facts and procedures I learnt and gathered throughout my professional career for a better understanding and for a culminating beneficial outcome should be always welcome. Not for who win or who loose.
Well it is high time I get to a long leave from you all.