The new codesas with codes for any vaginal or laparoscopic approachare selected based on 1) the documented weight of the uterus and 2) whether the fallopian tubes or ovaries have been removed. Frequently asked questions. In some cases, the surgery also removes the ovaries and fallopian tubes. Note the instruction in CPT that +57267 is for use with 45560, 57240-57265, and 57285, only. The robot was undocked, the ports removed, allowing escape of the pneumoperitneum. Second degree is also incomplete with the uterus dropping into the lower portion of the vagina. When compared to other types, hysterectomy through the vagina is minimally invasive, so recovery is normally shorter and easier. Therefore, patients need to limit their activities for a few weeks and follow the post-operative instructions carefully. Simplify Medical coding Institute. Patients may also experience mild pain, discomfort in the lower belly and bloating or constipation as the bowel has temporarily slowed down. A Foley catheter was inserted, draining clear yellow urine. The 2022 edition of ICD-10-CM Z90. Excision or destruction (List separately in addition to code for primary procedure) 58615 Occlusion of fallopian tube(s) by device (eg, band, clip, Falope ring) vaginal or suprapubic approach Greater ability to address pelvic floor support 6. 58263 - CPT Code in category: Vaginal hysterectomy, for uterus 250 g or less. The codes would be: 57288, 57425-80 and 58542-80. Some women are able to go home the day of the surgery. Documentation for hysterectomy includes identifying the uterine arteries and ligation of cardinal and uterosacral ligaments. The uterine vessels bilaterally were skeletonized and cauterized with bipolar cautery. Your surgeon makes an incision inside your vagina to get to the uterus, Using long instruments, your surgeon clamps the uterine blood vessels and separates your uterus from the connective tissue, ovaries and fallopian tubes, Your uterus is removed through the vaginal opening, and absorbable stitches are used to control any bleeding inside the pelvis. As soon as the hysterectomy procedure is complete, patients will be shifted to a recovery room and their heart rate, blood pressure, level of pain and feelings of nausea will be closely monitored. The vaginal cuff was closed with figure of eight sutures of 2-0 PDS on either corner, and then running the cuff between the corners with 2-0 PDS. Has any NBA team come back from 0 3 in playoffs? Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions. The 8 mm sites were closed with skin glue. CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Feetool. We also use third-party cookies that help us analyze and understand how you use this website. Whatsapp: +91 9360951544.CPT code for Vag. LSH includes laparoscopically detaching the body of the uterus down to the uterine arteries. Who was responsible for determining guilt in a trial by ordeal? The bladder was intact and normal looking, with no evidence of trauma or perforation. What is the difference between CPT code 58571 and 58552? What is the ICD 10 code for hysterectomy? Resources Hysterectomy often includes removal of the cervix as well as the uterus. Contact your doctor if pain worsens or if you develop nausea, vomiting or bleeding thats heavier than a menstrual period. See our privacy policy. 409 12th Street SW, Washington, DC 20024-2188, Privacy Statement Out of these, the cookies that are categorized as necessary are stored on your browser as they are essential for the working of basic functionalities of the website. Outsource Strategies International is one of the leading medical billing and coding companies in the medical outsourcing space focused on all aspects of revenue cycle management. N92 Excessive, frequent and irregular menstruation Now, the procedures undertaken are Vaginal Hysterectomy. As a contributor you will produce quality content for the business of healthcare, taking the Knowledge Center forward with your knowhow and expertise. Hired for her dental expertise, Amber brings a wealth of knowledge and understanding of the dental revenue cycle management (RCM) services to MOS. She is experiencing pelvic pain and urinary incontinence with cough and sneeze. This is considered a routine component of the hysterectomy procedure and cannot be separately coded. Cancel anytime. 58571Laparoscopic total hysterectomy for uterus 250g or less; with removal of tube(s) and/or ovary(s) 58572Laparoscopic total hysterectomy for uterus greater than 250g. 2 What is the CPT code for bilateral salpingo-oophorectomy? We are looking for thought leaders to contribute content to AAPCs Knowledge Center. Subscribers will be able to see codes in a code-book page-like view here. You will be able to see the most common modifiers billed to Medicare along with this code. The pneumoperitneum pressure was brought down to 5 mm Hg and all sites were hemostatic. by Meghann Drella | Last updated Dec 5, 2022 | Published on Oct 30, 2018 | Blog, Medical Coding. Cystocele/rectocele repair 57260-51 58552 is a LAVH. A colporrhaphy repairs a prolapse into the vaginal canal. If you work with several fee schedules or would like to create custom fee comparison reports, you need our exclusive Compare-A-Feetool. Vaginal hysterectomy treats various gynecological problems, including: Fibroids. Peggy is a national speaker for AAPC. Its normal to have bloody vaginal discharge for several days to weeks after a hysterectomy, so youll need to wear sanitary pads. There are several things to avoid for a smooth recovery . This cookie is set by GDPR Cookie Consent plugin. Where appropriate, there are also Pre- and Post-service descriptions. American Hospital Association, Coding Clinic for ICD-19-CM, Total Laparoscopic Abdominal Hysterectomy and Laparoscopically Assisted Vaginal Hysterectomy, First Quarter 2012, pages 3-4: www.cdc.gov/nhsn/pdfs/commup/coding-guidance-lap-hyst-april2012.pdf Anterior colporrhaphy (57240 Anterior colporrhaphy, repair of cystocele with or without repair of urethrocele, including cystourethroscopy, when performed) involves the bladder; a posterior colporrhaphy (57250 Posterior colporrhaphy, repair of rectocele with or without perineorrhaphy) involves the rectal area. Where in the anterior colpo is an integral part. The 10/12 mm port site was closed with 4-0 Monocryl in a subcuticular fashion. The Foley catheter was removed and a 70-degree cystoscope was inserted into the bladder. The CPT codes for these procedures include: 58570Laparoscopic total hysterectomy for uterus 250g or less. Your first option is to report 58270 ( Vaginal hysterectomy, for uterus 250 grams or less; with repair of enterocele) with 57260-51 ( Combined anteroposterior colporrhaphy; multiple procedures ). You also have the option to opt-out of these cookies. View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. Access to this feature is available in the following . The cookie is set by GDPR cookie consent to record the user consent for the cookies in the category "Functional". A supraumbilical incision was made under 1/2% bupivicaine with epinephrine local anesthesia and a Veress needle placed into the abdominal cavity. What is CPT code for vaginal hysterectomy? Laparoscopic supracervical hysterectomy (LSH) 58541-58544 The structures are detached through the scope and tissue is morcellated* into smaller pieces and removed through the scope. The uterus is then removed through the vagina. Berkowitz LR, et al. <> A series of #2-#0 Vicryl interrupted sutures were then placed sequentially along the lateral folds of the vesicovaginal space and brought together to tuck the bladder back while simultaneously bringing the lateral vaginal tissues together. Paravaginal defect repair 57284 After this procedure, a woman may no longer have menstrual periods and cant become pregnant. Simplify Medical coding Institute. Two 8 mm robotic ports were placed under direct visualization in the right abdomen, one 8 mm robotic port placed in the left abdomen, and a 10-12 mm port placed also in the left abdomen, all under direct visualization. The uterus is then removed through the vagina or abdomen. A sling is synthetic tissue or fascia that forms a hammock under the urethra, attaching it to a structure in the pelvis. CPT Code2 Description Physician 3 Ambulatory Surgical Center 4 Hospital Outpatient Hysterectomy Continued 58260 Vaginal hysterectomy, for uterus 250 g or less; Facility Only: $865 $1,910 $4,503 58262 Vaginal hysterectomy, for uterus 250 g or less; with removal of tube(s), and/or ovary(s) Facility Only: $955 $1,910 $4,503 ACOG Coding staff has developed laparoscopic hysterectomy charts that summarize the differences in these procedures. Risks of vaginal hysterectomy include: Severe endometriosis or scar tissue (pelvic adhesions) might force your surgeon to switch from vaginal hysterectomy to laparoscopic or abdominal hysterectomy during the surgery. Stilley has more than 30 years of experience in the healthcare industry starting as a medical assistant, expanding her duties to billing and coding, and management in a teaching facility. Obstetrics and Gynecology medical billing and coding is challenging, as it involves numerous rules related to reporting the procedure accurately. Colpopexy is a repair of prolapsed vaginal tissue, which may be performed at the same operative session as a hysterectomy and is billed separately. All payers will require diagnosis codes to support the medical necessity for the procedure(s). 57285 vaginal approach 58575 ), Related CPT CodeBook Guidelines (Reverse Guideline Lookup). Insertion of mesh +57267 Vaginal hysterectomy is a common procedure in gynecology practice, and medical coding for the same is a real challenge due to many code choices. View a table of UCR, Worker's Comp, and Medicare Fees here, as well as see UCR Fees in the charts below. You might feel a sense of loss and grief after hysterectomy, which is normal. When the surgeon also removes one or both ovaries and fallopian tubes, its called a total hysterectomy with salpingo-oophorectomy (sal-ping-go-o-of-uh-REK-tuh-me). American College of Obstetricians and Gynecologists The cookie is used to store the user consent for the cookies in the category "Performance". Based on the technique the most appropriate procedure code for vNOTES hysterectomy is code 35750-00 [1269] Laparoscopic assisted vaginal hysterectomy . LAVH includes laparoscopically detaching the uterine body from the surrounding upper supporting structures. CPT 57267 is an add-on code used for application of mesh. How do food preservatives affect the growth of microorganisms? Thank you so much, so I have 58260 (22), 51860 (59) and 52000. 5 What is the CPT code for radical hysterectomy? Walters MD. Your doctor will talk to you about other surgical options, such as an abdominal hysterectomy. All rights reserved. The cuff is typically closed from above using trocars. I have a surgeon that assisted another surgeon with a robotic hysterectomy with BSO and robotic sacrocolpopexy and then was the primary surgeon for her midurethral sling. The patient had a Vaginal Hysterectomy (uterus), Anterior Coloporrhaphy, Repair of Cystotomy and Cystoscopy. What is the CPT code for bilateral salpingo-oophorectomy? If the weight of the uterus is not documented before being sent to pathology, can the path report be used? Viewhistorical information about the code including when it was added, changed, deleted, etc. After a hysterectomy, youll no longer have periods or be able to get pregnant. Do not separately report cystocele with 57284 or 57285. Although hysterectomy is a common procedure in gynecology practice, coding for it is a challenge due to so many code choices. Viewhistorical information about the code including when it was added, changed, deleted, etc. Hysterectomy is the second most frequently performed surgical procedures in the United States with reports suggesting about 650,000 procedures being performed each year. Although it is not in numerical sequence with TLH, you would also include laparoscopic radical hysterectomy with pelvic lymphadenectomy (CPT 58548) in this code set. Sterile dressings were applied. The peritoneum was opened anteriorly from the broad ligaments bilaterally down over the lower uterus. She was then placed in the dorsal lithotomy position and underwent examination under anesthesia. vaginal . The most common medical reasons for doing a hysterectomy include benign fibroid tumors of the uterus, abnormal uterine bleeding, endometriosis, genital prolapse, and chronic pelvic pain. Slings support the urethra and bladder, and can be performed vaginally (57288 Sling operation for stress incontinence (eg, fascia or synthetic) or laparoscopically (51992 Laparoscopy, surgical; sling operation for stress incontinence (eg, fascia or synthetic)). The coding solution depends on documentation. The extent of the procedure performed is another important detail. Consider each procedure when making the determination. Note: All of the above coding guidelines are provided in CPT and may vary from the Center for Medicare & Medicaid Services (CMS) guidelines. For those who are undergoing vaginal hysterectomy, regional anesthesia will be preferred as it will block the sensation in the lower half of your body. Suspension procedures which do not involve Discover how to save hours each week. 3 0 obj Vaginal hysterectomy. N80 Endometriosis Could you please send the op notes and the preop. Codes include: The CPT codes for vaginal hysterectomy include - 58260 - Vaginal hysterectomy, for uterus 250 g or less 58262 - Vaginal hysterectomy, for uterus 250 g or less; with removal of tube (s), and/or ovary (s) 58263 - Vaginal hysterectomy, for uterus 250 g or less; with removal of tube (s), and/or ovary (s), with repair of enterocele In this example, since all of the structures are detached through the laparoscope, it is a TLH. Mayo Clinic. The patient was taken to the OR, where her anesthetic was induced. Make a donation. The surgeon enters the space of Retzius and re-attaches the lateral vagina to the level of the white line, or arcus tendineus fasciae pelvis. Save time with a Professional or Facility subscription! The insertion of mesh is bundled with the sling. The laparoscopic instruments are able to make the incisions around the vaginal area while staying away from the ureters and vaginal fornix. https://www.acog.org/Patients/FAQs/Hysterectomy. Coding clinic replied that a code from CPT code range 58260-58294 was to be selected as it captured the vaginal hysterectomy based on what was performed during the operation and the weight of the uterus and that although a laparoscopic device was utilized, the hysterectomy was still performed vaginally. Ullom AL. View a chart showing the last 8+ years of Medicare denial rates, Medicare Allowed amounts, and Medicare billed amounts. registered for member area and forum access. Each of the code sets are subdivided into uteri less than or greater than 250 grams and with or without removal of tube (s) and/or ovary (s). The vaginal portion of the procedure is then performed. The CPT code 57260 (combined anteroposterior colporrhaphy) can now be billed at the time of vaginal hysterectomy without any modifier, as this coding edit has been dropped. ![e& O{Q*#andN7 Copyright 2023, AAPC Bilateral ureteric jets were visualized. Documentation should state the weight of the uterus before it is sent to pathology. V+dZsnwy2kP|~+}vy]a]54WM=i/)OkOP$h5% bF jc A,1XB2;OEBFE 7x$u]#m^mC PDPP(M4W&/M$qvr=X!#OXzG6N=Xf6+Ln`9sQFDX]1p; ;HY\jUMAi*r`s]SEzHjVaOA51|(^P7cVya-$)v Q4p2=3qc'{r&fDWj\2u:nQw:|N?(1~~B{0 }6sYgbHI#c@b10sQ4y):PK-\; The average period of hospital stay after the procedure is generally two days or possibly longer. Enjoy a guided tour of FindACode's many features and tools. Other uncategorized cookies are those that are being analyzed and have not been classified into a category as yet. The other CPT code sets are the laparoscopy with vaginal hysterectomy (LAVH) (58550-58554) and laparoscopic supracervical hysterectomy (LSH) (58541-58544) code sets. Calculated for National Unadjusted (00000), Clinical Labor (Non-Facility)- Direct Expense, Additional Code Information (Global Days, MUEs, etc. N80-98 Noninflammatory disorders of female genital tract The new code, 58575, Laparoscopy, surgical, total hysterectomy for resection of malignancy (tumor debulking), with omentectomy including salpingo-oophorectomy, unilateral or bilateral, when performed, has been valued at 53.62 RVUs. The excess vaginal mucosa was then trimmed. Loralee joined MOS Revenue Cycle Management Division in October 2021. The patient was now placed in steep Trendelenburg position, and the robot was docked from the patients right side. Vaginal hysterectomy 58260 Vaginal hysterectomy, for uterus 250 g or less reverse_index/reverse_index_content.php?set=CPT&c=58280, cpt/cpt_reference_guidelines_content.php?set=CPT&c=58280, newsletters/newsletter_content.php?set=CPT&c=58280, webacode/webacode_content.php?set=CPT&c=58280, medlabtests/medlabtests_content.php?set=CPT&c=58280, crosswalks/crosswalk_content.php?set=CPT&c=58280, ncciedits/ncci_content.php?set=CPT&c=58280, coverage/coverage_content.php?set=CPT&c=58280, commercial-payers/commercial-payers-content.php?set=CPT&c=58280, NPI Look-Up Tool (National Provider Identifier), Major Complications or Comorbidities (MCC/CC), Create UNLIMITED Customized Fee Schedule reports - for ALL localities, ALL specialties, See fees for ALL localities (all ZIP codes) as well as National fees, Load UNLIMITED Fee Schedules with your fees or fees from your payers, Choose to compare fees (national or adjusted for your locality) from built-in data sets and the fee schedules you enter. The procedure concludes with the top part of the vagina being sutured, removal of instruments and closure of the incisions. Every vignette contains a Clinical Example/Typical Patient and a description of Procedure/Intra-service. She was previously a member of AAPCs ICD-10 Training and Education team, and Director of Audit Services for AAPC Client Services. CPT code information is copyright by the AMA. Hysterectomy fact sheet. Using long instruments, your surgeon clamps the uterine blood vessels and separates the uterus from the connective tissue, ovaries and fallopian tubes. *A morcellator is a surgical instrument that minces tissue into small pieces, which are removed through the scope. Both procedures allow your surgeon to remove the uterus vaginally while being able to see your pelvic organs through a slender viewing instrument called a laparoscope. When both anterior and posterior colporrhaphy are performed, report 57260 Combined anteroposterior colporrhaphy, including cystourethroscopy, when performed. This code includes the removal of the tubes and ovaries, if performed. Please try reloading page. 58267 Vaginal hysterectomy, for uterus 250 g or less; with colpo-urethrocystopexy (Marshall-Marchetti-Krantz type, Pereyra type) with or without endoscopic control . CPT code information is copyright by the AMA. The FDA has stated that power morcellators should not be used in women with uterine fibroids due to the risk of spreading unsuspected cancerous tissues. <> Source: Laparoscopic Power Morcellators, retrieved from: www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/SurgeryandLifeSupport/ucm584463.htm. 2002 2023. Available for over 5000 of the most common CPT codes. The vaginal apex is entered and the cervix and uterus are detached from the remaining supporting structures. Example 1: Consider reporting for the following: 2 0 obj partial vs. complete). Analytical cookies are used to understand how visitors interact with the website. The CPT codes for these procedures include: 58570Laparoscopic total hysterectomy for uterus 250g or less. During a vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it, before removing the uterus. Patients need to lie in a position similar to that for a Pap test. How long does a 5v portable charger last? CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. Sling operation for SUI 57288-51 Multiple procedures Allscripts EPSi. All Rights Reserved. I am wondering what order I should enter these codes. To code prolapse repairs, the operative report should mention ligaments and supporting structures, approach for the procedure, and how the prolapse was repaired. This surgery includes laparoscopic supracervical hysterectomy (LSH) using CPT 58541 to CPT 58544. In most cases, a full recovery may take up to 2-3 weeks. In the article Pinpoint Correct Hysterectomy Coding (August 2018, pages 16-18), the statement, a laparoscopic-assisted vaginal approach a subset of the vaginal approach in which a scope is inserted via small incisions in the vagina, is incorrect, and is not the basis for coding a laparoscopically assisted vaginal hysterectomy (LAVH) versus a total laparoscopic hysterectomy (TLH). CPT code information is copyright by the AMA. Subtotal 58180 Supracervical abdominal hysterectomy (subtotal hysterectomy), with or without removal of tube(s), with or without removal of ovary(s); or The first code set is categorized as Laparoscopic Supracervical Hysterectomy (LSH), indicated by CPT codes 58541 to 58544. 1 0 obj Office on Women's Health. Both ureters were visualized, were peristalsing, and appeared to be of normal caliber. A member of your surgical team will clean the surgical area with a sterile solution before surgery. If this is your first visit, be sure to check out the. For a better experience, please enable JavaScript in your browser before proceeding. If you have both ovaries taken out, you will enter menopause. The ovaries, fallopian tubes, uterus, cervix and vagina (vaginal canal) make up the female reproductive system. Specifically, "Vaginal Hysterectomy Coding Update: Claims Eligible for Resubmission on April 1, 2015" explains the use of modiifiers when billing vaginal hysterectomy codes with concomitant prolapse repair codes in great detail. Monopolar Hot Shear scissors were placed in the medial right robotic port, and fenestrated bipolar forceps in the left robotic port. See our privacy policy. Medications to reduce pain and prevent infections will be directly administered. Accessed Nov. 6, 2018. You are using an out of date browser. Subscribers may add their own notes as well as "Admin Notes" visible to all subscribers in their account. To narrow down your choices look for the surgical approach and extent of the procedure. Basic and Advanced Medical coding. If you can bill for it, the codes would be reported as 58260 ( vaginal hysterectomy) or 58262 ( vaginal hysterectomy; with removal of tube [s] and/or ovary [s], and 57280-51 or 57282-51, using the modifier for multiple procedures.) Online Courses offered. No charge. The surgical approach can be abdominal (the uterus is removed via an incision in the lower abdomen), vaginal (the uterus is removed via an incision in the vagina), or laparoscopic (procedure is performed using a laparoscope, inserted via several small incisions in the body). View calculated CPT fee values specifically for your Medicare locality. View calculated CPT fee values specifically for your Medicare locality. Vaginal hysterectomy - 58260 Paravaginal defect repair - 57284 Posterior repair - 57250 Insertion of mesh - +57267 The coding solution depends on documentation. Accessed Nov. 6, 2018. CPT includes more than 30 hysterectomy codes. This content does not have an English version. These cookies track visitors across websites and collect information to provide customized ads. or call toll-free from U.S.: (800) 762-2264 or (240) 547-2156 Special procedures FAQ008. endobj The CPT index, under the main term hysterectomy, lists your code choices according to the type of approach documented. Radical hysterectomy includes the removal of the entire uterus and nearby tissue, the cervix, and the top part of the vagina. N81 Female genital prolapse TLH includes laparoscopically detaching the entire uterine cervix and body from the surrounding supporting structures and suturing the vaginal cuff. The ICD-10-CM codes are N81.2 Incomplete uterovaginal prolapse for a second-degree uterovaginal prolapse and N39.3 Stress incontinence (female) (male). Meghann joined MOS Revenue Cycle Management Division in February of 2013. However, depending on the size and shape of your uterus or the reason for the surgery, vaginal hysterectomy might not be possible. The needle was removed and replaced with a 12 mm port. There is also a laparoscopic-assisted vaginal approach a subset of the vaginal approach in which a scope is inserted via small incisions in the vagina. Peggy has more than 30 years of experience in the healthcare industry and has worked in a variety of positions. For additional quantities, please contact [emailprotected] This cookie is set by GDPR Cookie Consent plugin. Depending on the patients condition, the procedure can last anywhere between 60 90 minutes. Along with the specific surgical approach and the extent (whether it's total or partial) of the hysterectomy, accounting for related performed procedures is vital to code selection. Tech & Innovation in Healthcare eNewsletter, Pressure Ulcer and Non-Pressure Ulcer ICD-10 Coding, ICD-10 Code Assignment for Pressure/Non Pressure Ulcers, Set a Pace for Better Implantable Defibrillator Coding, CPT 2018: E/M Aligns with Quality Care Initiatives. Any use of this site constitutes your agreement to the Terms and Conditions and Privacy Policy linked below. Laparoscopy with vaginal hysterectomy (LAVH) can be billed with CPT 58541 to CPT 58544. This, in addition to the laparoscopic radical hysterectomy with pelvic lymphadenectomy code (58548), is the third set of CPT codes addressing the laparoscopic approach to hysterectomy. Do you code cystoscopy with hysterectomy? Free text is to be used to specify vNOTES hysterectomy. For most women, theres no change in sexual function after hysterectomy. She was then prepped and draped in the usual manner for vaginal and abdominal surgery. % Before 2008, the only coding choices were laparoscopic-assisted hysterectomy codes (58550-58554) or the unlisted laparoscopic code 58578. The final code set is for Total Laparoscopic Hysterectomy (TLH), indicated by CPT codes 58570 to 58573. CPT/ICD9: Code Facility Service Date PROVIDER: Name ID# Phone# Signature Date ICD-9-CM: 65.61, 68.51 . CPT code information is copyright by the AMA. Enjoy a guided tour of FindACode's many features and tools. Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press. 1. Bulk pricing was not found for item. 57284 Paravaginal defect repair (including repair of cystocele, if performed); open abdominal approach CPT Code Set 58552 - CPT Code in category: Laparoscopy, surgical, with vaginal hysterectomy, for uterus 250 g or less CPT Code information is available to subscribers and includes the CPT code number, short description, long description, guidelines and more. | Terms and Conditions of Use. Note that 57240 and 57260 were revised in 2018 to include cystourethroscopy, when performed. CPT also added an instructional note explaining 57240 and 57260 cannot be billed with 52000 Cystourethroscopy (separate procedure). American College of Obstetricians and Gynecologists. As part of vaginal hysterectomy, the surgeon detaches the uterus from the ovaries, fallopian tubes and upper vagina, as well as from the blood vessels and connective tissue that support it. A total hysterectomy is the removal of the whole uterus, the fundus, and cervix.
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