Wiki vaginal cuff dehiscence repair by laparoscope

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kcurry1

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Does anyone know how I would code repair of vaginal cuff dehiscence by laparoscope.

Description: The vaginal cuff was inspected. There was some mild inflammation on the bladder peritoneal surface as well as the vag. cuff area. There was no pelvic collection or purulent discharge at the cuff. THe edges of the vaginal cuff wre debrided removing fibrinous proteinaceous material at the cuff until healthy tissue was exposed. The cuff was then closed from the vagina using interrupted figure of eight stitches of 0 vicryl under direct visualization with the laparoscope. Excellant hemostasis was noted. The cuff was closed under direct visualization using the laparoscope to ensure that bowel and bladder are not incorporated into vag cuff sutures.
 
I am using 49329, the unlisted laparoscopy of abdomen code. I am equating the code (in the free text area) to 57425, a colpopexy procedure performed laparoscopically.
 
You are fine.Was it a prev hysterectomy case?
But I feel the code 57423 Paravaginal defect Repair, laparoscopic approach would be more appropriate for this scenario.
Why? : because the procedure done now, was for a scar defect/ or dehescence of the vaginal cuff (of a previous hysterectomy) and on the vaginal cuff/vault, sutured before during the surgery of hysterctomy ( as a step to close the gap/communication between the abdomen and the vaginal region, which happens as a result of uterus being removed), sometimes gives a defect in the paravaginal tissues which remains there and hence a dehiscence, which was repaired now..
This procedure colpopexy wihc is done for suspension effect not for a repair effect or purpose.
I hope I make some point at this juncture. Thank you.
 
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