Dallas KB, Rogo-Gupta L, Elliott CS. Urologic injury and fistula after hysterectomy for benign indications. Obstet Gynecol 2019;134.
The authors provided this information as a supplement to their article.
©2019 American College of Obstetricians and Gynecologists. Page 1 of 5
Appendix 1. Index Procedure Codes
Outpatient CPT Inpatient ICD-9
Prolapse Repair
57120 Colpocleisis 69.21 Uterine suspension
57240 Repair of cystocele 69.22 Other uterine suspension
57250 Repair of rectocele 69.23 Vaginal repair of chronic inversion of uterus
57260 Repair of cystocele and rectocele 69.29 Other repair of uterus and supporting structures 57265 Repair of cystocele, rectocele, and enterocele 69.98 Other operation on supporting structure of the uterus 57268 Repair of enterocele via vaginal approach 70.50 Repair of cystocele and rectocele
57282 Colpopexy via extraperitoneal vaginal approach 70.51 Repair of cystocele 57283 Colpopexy via intraperitoneal vaginal approach 70.52 Repair of rectocele
57284 Paravaginal defect repair 70.53 Repair of cystocele and rectocele with graft
*
58152 Hysterectomy and cystocele 70.54 Repair of cystocele with graft
*
58267 Hysterectomy and cystocele 70.55 Repair of rectocele with graft
*
58270 Hysterectomy with repair of enterocele 70.62 Vaginal reconstruction 58280 Hysterectomy Vaginal and partial vaginectomy with repair of
enterocele
70.64 Vaginal reconstruction with mesh
*
58292 Hysterectomy Vaginal (>250 g) with removal tube +/− ovary and repair of enterocele
70.77 Vaginal suspension
58293 Hysterectomy vaginal (>250 g) with colpo-urethrocystopexy 70.78 Vaginal suspension with graft
*
58294 Hysterectomy with repair of enterocele 70.80 Colpocleisis
58400 Uterine suspension 70.92 Other operation of the cul-de-sac (includes obliteration of cul-de-sac and enterocele repair)
58410 Uterine suspension with presacral sympathectomy 70.93 Other operation of the cul-de-sac with graft
*
70.94 Other operation of the cul-de-sac with biologic graft 70.95 Other operation of the cul-de-sac with synthetic mesh
*
Incontinence Procedure
51715 Cystoscopic injection of urethral bulking agent 57.85 Cystourethroplasty
51840 Retropubic urethral suspension 57.89 Bladder suspension not otherwise specified
51845 Needle suspension 59.30 Plication of the urethrovesical junction
57288 Mid-urethral sling 59.40 Suprapubic sling operation
57289 Pereyra procedure 59.50 Retropubic urethral suspension
59.60 Paraurethral suspension
59.70 Other repair for stress urinary incontinence Hysterectomy Procedure
58150†, 58152†, 58180†, 58260‡, 58262‡, 58263‡, 58267‡, 58270‡, 58275‡, 58280
‡, 58285‡, 58290‡, 58291‡, 58292‡, 58293‡, 58294‡,58541-58544§, 58550-58554§ 68.3†, 68.4†, 68.6†, 68.39†, 68.49†, 68.69†, 68.5‡, 68.7‡, 68.79‡, 68.39, 68.49, 68.59, 68.69, 68.79, 68.8, 68.9, 68.31§, 68.41§, 68.51§, 68.61§, 68.71§
*
Classified as mesh use. Also classified as mesh use if modifier was present (57267: Insertion of mesh or other prosthesis for repair of pelvic floor defect)† Abdominal approach
‡Vaginal approach
§Laparoscopic approach
Dallas KB, Rogo-Gupta L, Elliott CS. Urologic injury and fistula after hysterectomy for benign indications. Obstet Gynecol 2019;134.
The authors provided this information as a supplement to their article.
©2019 American College of Obstetricians and Gynecologists. Page 2 of 5
Appendix 2. Cancer Exclusions Codes
ICD-9 Diagnosis Codes
179 Malignant neoplasm of uterus, part unspecified
180 Cervical canal NOS
180.1 Cancer exocervix
180.8, 180.9, 182.0, 182.1, 182.8, 233.1 Other specified sites of cervix
183, 198.6, 236.2 Ovarian malignancy
183.2 Fallopian tube
182.0, 183.3, 183.4,183.5, 183.8, 183.9, 233.1, 233.2, 236.0, V10.42
Uterine malignancy
233.9 Other and unspecified urinary organs
236.1 Placenta malignancy
184, 184.1,184.2, 184.3,184.4,184.8, 184.9, 198.82, 233.3, 233.30, 233.31, 233.32, 233.39, V10.40
Vaginal/Vulvar malignancy 188.0-188.9, 198.1, 233.9, 236.7, 236.9, 236.90, 236.99,
239.4, V10.51, V10.44, V10.50
Bladder cancer 153.0-154.3,154.8, V10.05, V10.06 Colorectal cancer
159.0,159.8, 159.9, 197.4, 197.5, 197.8, 239.0 Other digestive organ malignancy
158.0,158.8,158.9, 197.6 Retroperitoneal, peritoneal malignancy
199, 199.1 Carcinomatosis, other malignancy
195.3 Other pelvic malignancy
V8741 Personal history of antineoplastic chemotherapy
V15.3 Personal history of radiation for malignancy
Dallas KB, Rogo-Gupta L, Elliott CS. Urologic injury and fistula after hysterectomy for benign indications. Obstet Gynecol 2019;134.
The authors provided this information as a supplement to their article.
©2019 American College of Obstetricians and Gynecologists. Page 3 of 5
Appendix 3. Codes Used to Identify Primary Diagnosis Associated With Hysterectomy, Diagnosis of Fistula, and Repair of Urologic Injury
Urologic Injury
Outpatient CPT Inpatient ICD-9
50840 Ileal Ureter 56.71, 56.73, 56.74 Ureteroneocystostomy
50785 Ureteral reimplant 56.75 Transureteroureterostomy
50783, 50700, 50770 57260
50760, 50780, 50783, 50785, 50947-50949
50900 52332, 50394 50395
Revision of ureter Fusion of ureters Ureteroneocystostomy Ureteral repair Indwelling stent Nephrostomy
56.40, 56.41, 56.79, 56.82, 56.83, 56.84, 56.85, 56.86, 56.89, 56.7
57.81, 57.82 59.80
55.93, 55.02, 55.03 55.92, 55.12
Other ureteral repair
Repair of cystotomy Indwelling stent Nephrostomy
Fistula
Outpatient CPT Inpatient ICD-9 57300,57320, 57330, 51900, 57300,57320, 57330,
57305,57037,57308, 51920, 51925
57.83, 57.84, 70.72-70.75,70.79 Diagnosis
617.4-617.9
621.3, 621.30-621.33, 626, 626.2, 626.4, 626.6 218.0-218.2, 218.9, 621.2
Endometriosis
Bleeding, Excessive menstruation Fibroid disease/Hypertrophy of uterus
Dallas KB, Rogo-Gupta L, Elliott CS. Urologic injury and fistula after hysterectomy for benign indications. Obstet Gynecol 2019;134.
The authors provided this information as a supplement to their article.
©2019 American College of Obstetricians and Gynecologists. Page 4 of 5
Appendix 4. Ureteral Injury Diagnosis Codes
ICD-9 Diagnosis Codes
867.2, 867.3 Injury of Ureter, without mention of open wound into cavity
593.3 Stricture or Kinking of Ureter
599.89, 599.9 Other specified disorders of urinary tract
593.5 Hydroureter
593.4, 753.2, 753.20 Obstruction of Ureter
591 Hydronephrosis
753.4, 593.89, 593.8, 753.4 Defect of Ureter, other 593.82
869, 869.0, 869.1 959, 862, 998.9, 66.94, 998.8, E870.0, E878.8, E878.9, E876.8, E876.9,
Fistula involving ureter Injury/complication NOS
Dallas KB, Rogo-Gupta L, Elliott CS. Urologic injury and fistula after hysterectomy for benign indications. Obstet Gynecol 2019;134.
The authors provided this information as a supplement to their article.
©2019 American College of Obstetricians and Gynecologists. Page 5 of 5
Appendix 5. Rates of Cystoscopy by Surgical Approach (a) and Type of Injury (b)
a.)
Cystoscopy performed n=18,013
Cystoscopy not performed n=278,117
Surgical Approach Timing of injury identification Timing of injury identification
Immediate Delayed Immediate Delayed
Abdominal Total n=109,188 Cystoscopy n=3,168 (2.9%)
328 (10.4%) 17 (0.5%) 1,502 (1.4%) 372
(0.4%) Vaginal
Total n=62,860 Cystoscopy n=7,103 (11.3%)
235 (3.3%) 38 (0.5%) 467 (0.8%) 184
(0.3%) Laparoscopic
Total n=77,415 Cystoscopy n=3,770 (4.9%)
208 (5.5%) 19 (0.5%) 667 (0.9%) 387
(0.5%) Laparoscopic Assisted Vaginal
Total n=36,348 Cystoscopy n=3,174 (8.7%)
145 (4.6%) 16 (0.5%) 254 (0.8%) 192
(0.6%) b.)
Delayed injury presentation rate Immediate injury presentation rate Cystoscopy
n=18,013
No Cystoscopy n=278,117
Cystoscopy n=18,013
No Cystoscopy n=278,117
Ureteral n=18 (0.1%) n=423 (0.2%) n=612 (3.4%) n=1,764 (0.6%) p<0.001
Bladder n=4 (0.02%) n=103 (0.03%) n=416 (2.3%) n=1,535 (0.6%) p<0.001
Fistula n=71 (0.4%) n=683 (0.2%) NA NA
