Coding Corner: Coding for Aborted Radical Hysterectomy | Stephen Bush II, MD
Gynecologic oncologists have all encountered situations where intraoperative conditions force them to change or abandon their surgical plans. Stephen Bush II MD, a member of the SGO Coding Subcommittee, describes a coding situation which provides a great template for the thinking process behind a discontinued procedure.
A 25-year-old with a stage 1B2 squamous cell carcinoma of the cervix is scheduled for a radical abdominal hysterectomy with bilateral ovarian transposition. The procedure is started. The retroperitoneum is opened and an enlarged common iliac lymph node is sent for frozen section. While waiting for frozen results, the retroperitoneal spaces are further opened and explored. No other enlarged lymph nodes are found. The pathologist calls: squamous cell carcinoma is identified in the enlarged common iliac lymph node. The radical hysterectomy is aborted and the ovaries are transposed above the pelvic brim. The para aortic lymph nodes are removed.