0US40ZZ
Reposition Uterine Supporting Structure to No Qualifier with No Device, Open Approach
Procedural Specifications
| Clinical Axis | Detail Definition |
|---|---|
| Section | 0 Medical and Surgical |
| Body System | U Female Reproductive System |
| Operation | S Reposition |
| Body Part | 4 Uterine Supporting Structure |
| Approach | 0 Open |
| Device | Z No Device |
| Qualifier | Z 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
Uterine Supporting Structure
Uterine supporting structures include the ligamentous and fascial attachments, such as the round, broad, cardinal, and uterosacral ligaments, that maintain the uterus in its normal anteverted position within the pelvis. Reposition procedures on these structures are performed to correct uterine prolapse or malposition, such as retroversion causing pain or infertility, by plicating, shortening, or resuspending the ligaments without removing tissue. Because these supports are thin and share close proximity to the ureters, bladder, and rectum, surgeons must carefully identify the correct fascial planes during procedures like uterosacral ligament suspension or round ligament plication to avoid injury to adjacent pelvic structures while restoring adequate uterine support.
Approach: Open
Open approach means the surgeon cuts through skin, mucous membrane, or other tissue layers to physically expose the target site to view before performing the procedure. It gives direct visualization and hands-on access, distinguishing it from Percutaneous approaches where instruments pass through a small puncture without exposing the site. Open is typical for procedures needing wide access, such as most laparotomies.
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.