SURGICAL PROCEDURES OPERATIONS ON THE FEMALE GENITAL SYSTEM

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1 In composite operations such as repair of cystocoele and rectocoele and D & C, or cystocoele and rectocoele and cauterization of cervix and biopsy, the fee shall, unless otherwise mentioned below, be that of the major procedure. VULVA Hymenotomy Abscess of vulva, Bartholin or Skene s gland (IOP) local anaesthetic general anaesthetic Perineotomy (IOP) Hymenectomy (with or without perineotomy) Vulvectomy simple - partial or total radical - without gland dissection - partial or complete resection with complete dissection of glands - uni or bilateral Cyst of Bartholin s gland Marsupialization of cyst (IOP) Condylomata - single or multiple (IOP) Chemical or more Surgical excision or electrodesiccation local anaesthetic general anaesthetic Cryosurgery - initial or subsequent treatment Laser destruction of vulval lesions local anaesthetic general anaesthetic Non-obstetrical injury to vulva and/or vagina, and/or perineum... IC IC IC IC Ligation of varicose vein of labia - uni or bilateral VAGINA Endoscopy (IOP) Colpomicroscopy of vagina (includes cervix) with biopsy and/or endocervical curettage T-1

2 VAGINA (Cont d) Colpotomy, posterior, drainage or needle puncture Culdotomy, incision and exploration Culdoscopy including biopsy (IOP) and drainage of cyst, abscess or haematoma Biopsy(s) - when sole procedure (IOP) local anaesthetic general anaesthetic Local excision of cyst of congenital vaginal septum Colpectomy, partial or complete, for non-malignant lesions (not to be used to claim for biopsy) Colpectomy, radical for malignancy Laser treatment of vagina under general anaesthesia Cystocoele or rectocoele Cystocoele and rectocoele Cystocoele, rectocoele and enterocoele Rectocoele and enterocoele Cystocoele, rectocoele and prolapse (Fothergill) Cystocoele, rectocoele and excision cervical stump Vaginal vault prolapse (post hysterectomy) or enterocoele Rectocoele and repair of anal sphincter Perineorrhaphy Colpocleisis Operation for artificial vagina Closure of fistula - vesico-vaginal surgeon surgeons - vaginal surgeon abdominal surgeon recto-vaginal (any repair) uretero-vaginal urethro-vaginal Urethral caruncle or prolapse of mucosa Retropubic urethropexy for stress incontinence Combined abdominal - vaginal procedure for stress incontinence surgeon surgeons - vaginal surgeon abdominal surgeon Manipulation Examination and/or dilation - general anaesthetic (IOP) T-2

3 FALLOPIAN TUBE (unilateral or bilateral) Salpingectomy and salpingo - oophorectomy Partial salpingectomy for sterilization Tubal plastic operation fimbriolysis - unilateral salpingostomy - unilateral resection with reanastomosis of extensive tubal and peritubal disease using operating microscope (not to be charged for reconstruction following previous sterilization procedures) uni or bilateral) Suture Ligation of tubes, all methods, all approaches OVARY (uni or bilateral) Biopsy of ovaries by laparotomy Wedge resection of ovaries (e.g. Stein-Leventhal) Oophorectomy Oophorectomy with omentectomy for malignant disease Oophorocystectomy Para ovarian cyst Oophorectomy with or without omentectomy for malignant disease and with pelvic and/or perioaortic lymphadenectomy Second look exploratory laparotomy including biopsies, when done as part of chemotherapy protocol for ovarian carcinoma with or without total omentectomy Culdectomy (extensive removal of pelvic peritoneum required for evacuation of malignancy extension of secondaries) UTERUS AND CERVIX UTERI Endoscopy (IOP) Colpomicroscopy (includes vagina) with biopsy and/or endocervical curettage Hysteroscopy with biopsy with cannulization of tubes T-3

4 UTERUS AND CERVIX UTERI (Cont d) Endometrial biopsy (IOP) Biopsy, cervix (IOP) Hysterotomy Cryoconization, electroconization with or without endocervical curettage (IOP) CO 2 laser therapy with or without curettage for CIN (Cervical Intra-epithelial Neoplasia) (IOP) NOTE: D & Cs are not billable in addition to code or Diagnostic curettage (with or without cauterization biopsy of cervix, removal of polypi or Rubin s test) (IOP) and hystero-salpingography (IOP) with knife conization of cervix (includes additional biopsies) Therapeutic hysteroscopy/endometrial ablation initial repeat procedure within 1 year Hysterectomy (with or without adnexa or enterocoele) Total, abdominal or vaginal with cystocoele and rectocoele with cystocoele or rectocoele Partial or subtotal with cystocoele and rectocoele with cystocoele or rectocoele Radical (total hysterectomy plus lymphadenectomy) Myomectomy Amputation of cervix Cervical stump - abdominal vaginal Introduction (IOP) Insufflation - Rubin s test Insufflation and endometrial biopsy Insertion of IUCD Hysteropexy (uterine suspension) with anterior and posterior repair with anterior or posterior repair Cervix, incompetent Trachelorrhaphy (plastic repair of cervix) - not immediately following delivery Hysteroplasty - excision of septum (Strassman) Unification of double uteri Uterine inversion - manual operative Presacral neurectomy T-4

5 UTERUS AND CERVIX UTERI (Cont d) Cautery of Cervix (IOP) Office - chemical cautery... VF VF electro-cautery or cryocautery Hospital, general anaesthetic, dilation and cauterization or conization, single procedure T-5

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