ICD-10-PCS Billable Code

0US28ZZ

Reposition Ovaries, Bilateral to No Qualifier with No Device, Via Natural or Artificial Opening Endoscopic Approach

Procedural Specifications

Clinical Axis Detail Definition
Section0 Medical and Surgical
Body SystemU Female Reproductive System
OperationS Reposition
Body Part2 Ovaries, Bilateral
Approach8 Via Natural or Artificial Opening Endoscopic
DeviceZ No Device
QualifierZ No Qualifier

Operation Definition

Moving to its normal location, or other suitable location, all or a portion of a body part

Procedure Overview

Reposition procedures involve surgically moving a female reproductive organ or structure to its normal anatomic location, or to another suitable location, without cutting away tissue or adding replacement material. This root operation is most often used for conditions where an organ has shifted out of place, such as uterine prolapse, or for procedures that relocate an ovary, such as ovarian transposition performed before pelvic radiation to protect fertility.

These procedures matter clinically because organ displacement in the pelvis can cause pain, urinary or bowel dysfunction, and infertility. Surgeons address this by suspending or anchoring the organ, sometimes using sutures to native tissue and sometimes attaching it to a nearby structure like the sacrum, but the code reflects the movement of the existing body part rather than any material that may be used to hold it there.

Anatomy & Axis Detail

Ovaries, Bilateral

Bilateral ovary repositioning refers to correcting the position of both ovaries in a single encounter, a scenario seen with bilateral torsion, extensive pelvic adhesions distorting normal adnexal anatomy, or prophylactic transposition performed before pelvic radiation therapy to preserve hormonal and reproductive function. Moving both ovaries out of the radiation field, typically to the paracolic gutters, is a recognized fertility-sparing technique in patients undergoing treatment for pelvic malignancies. Documentation should clarify the reason repositioning was bilateral, since simultaneous involvement of both ovaries carries different clinical implications than a unilateral finding, and the surgeon's approach to fixation, whether by suture to the abdominal wall or lateral peritoneum, should also be noted.

Approach: Via Natural or Artificial Opening Endoscopic

Via Natural or Artificial Opening Endoscopic describes instrumentation introduced through a natural orifice or a surgically created opening while using an endoscope for visualization, as in a routine colonoscopy performed through the anus. It differs from the plain Via Natural or Artificial Opening value by the added scope, and from Percutaneous Endoscopic by using an existing passage rather than a new skin puncture.

Coding & Documentation

Coders assign a Reposition code when the operative report describes moving an organ or structure to correct its position, using language like suspension, fixation, transposition, or resuspension. The documentation should identify both the structure being repositioned and, where relevant, the anatomic landmark it is anchored to, since this can affect approach and code specificity.

A frequent mistake is coding Reposition when sutures or mesh were placed primarily to reinforce weakened tissue rather than to move an organ, which instead falls under Supplement. Another common error is failing to recognize that if sutures alone are used to anchor a structure with no added material, Reposition is correct even though a repair-sounding term may appear in the note; coders need to read past the surgeon's word choice to the actual mechanics described.

Commonly Confused With

RepairReposition is easily confused with Repair when a prolapse procedure also involves suturing native tissue, since both involve stitching.
SupplementIt is also confused with Supplement when synthetic mesh is used for support, since many modern prolapse repairs combine an organ's relocation with mesh reinforcement, which may require coding both root operations if the documentation supports each distinctly.