The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on laparoscopic techniques for hysterectomy.

Description

Hysterectomy is the surgical removal of the uterus. This may be used to treat women with various conditions including chronic pelvic pain, heavy periods, fibroids, or cancer of the uterus or the ovaries. Conventional hysterectomy is performed through an incision in the abdomen or through the vagina. In laparoscopic techniques for hysterectomy, special surgical instruments are inserted through small incisions made in the abdomen, and the operation is carried out with the aid of an internal telescope and camera system. This is sometimes described as 'keyhole surgery'. Part of the operation may also be performed vaginally.

Coding recommendations

Laparoscopic hysterectomy (LH):

Q07.4 Total abdominal hysterectomy NEC

Includes: Hysterectomy NEC

Y75.2 Laparoscopic approach to abdominal cavity NEC

Note: If the clinical record is  more specific, then another code may be appropriate from category Q07.- with the addition of Y75.2

Laparoscopic Vaginal Hysterectomy (LVH):

Q08.9 Unspecified vaginal excision of uterus

Includes: Vaginal hysterectomy NEC

Y75.2 Laparoscopic approach to abdominal cavity NEC

Note: If the clinical record is more specific, then another code may be appropriate from category Q08.- with the addition of Y75.2

Laparoscopically Assisted Vaginal Hysterectomy (LAVH):

Q08.9 Unspecified vaginal excision of uterus

Includes: Vaginal hysterectomy NEC

Y75.1 Laparoscopically assisted approach to abdominal cavity

Note: If the clinical record is more specific, then another code may be appropriate from category Q08.- with the addition of Y75.1