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Official Description

Endometrial ablation, thermal, without hysteroscopic guidance

© Copyright 2026 American Medical Association. All rights reserved.

Common Language Description

Endometrial ablation, specifically thermal endometrial ablation without hysteroscopic guidance, is a medical procedure aimed at treating certain benign conditions of the uterus, particularly menorrhagia, which is excessive menstrual bleeding often resulting from dysfunctional uterine bleeding. This procedure utilizes heat to destroy the endometrial tissue, which is the lining of the uterus. By applying thermal energy, the procedure effectively reduces or eliminates the source of abnormal bleeding. The absence of hysteroscopic guidance indicates that the procedure is performed without the use of a hysteroscope, a thin, lighted tube that allows for direct visualization of the uterine cavity. Instead, the procedure relies on other methods to ensure proper placement and effectiveness. Prior to the ablation, a baseline transvaginal ultrasound is conducted to assess the uterine condition, followed by the insertion of a balloon catheter into the uterine cavity, which is then inflated with heated water to achieve the desired therapeutic effect on the endometrial lining.

© Copyright 2026 Coding Ahead. All rights reserved.

1. Indications

The procedure of thermal endometrial ablation without hysteroscopic guidance is indicated for the treatment of specific benign conditions related to the uterus. These include:

  • Menorrhagia - This condition is characterized by excessive menstrual bleeding, which can significantly impact a patient's quality of life. It is often associated with dysfunctional uterine bleeding, where the normal regulation of the menstrual cycle is disrupted.

2. Procedure

The thermal endometrial ablation procedure involves several key steps to ensure effective treatment of the uterine lining. The steps are as follows:

  • Step 1: Baseline Transvaginal Ultrasound - Before the procedure begins, a baseline transvaginal ultrasound is performed. This imaging technique allows the physician to assess the condition of the uterus and confirm the presence of any abnormalities that may be contributing to the patient's symptoms.
  • Step 2: Preparation - Following the ultrasound, the vaginal probe used for the ultrasound is removed. A speculum is then inserted into the vagina to provide access to the cervix. This step is crucial for the subsequent placement of the balloon catheter.
  • Step 3: Cleansing the Cervical Os - The cervical os, which is the opening of the cervix, is cleansed to reduce the risk of infection and ensure a sterile environment for the procedure.
  • Step 4: Insertion of Balloon Catheter - A balloon catheter is carefully placed through the cervix and into the uterine cavity. This catheter is designed to facilitate the delivery of heated fluid to the uterine lining.
  • Step 5: Inflation of the Balloon - Once the catheter is in place, the balloon is inflated by filling it with water that has been heated to a high temperature. This heated water is essential for the thermal ablation process, as it effectively destroys the endometrial tissue lining the uterus.

3. Post-Procedure

After the thermal endometrial ablation procedure, patients may experience some discomfort and cramping, which is typical following such interventions. It is important for patients to follow any post-procedure care instructions provided by their healthcare provider. Monitoring for any unusual symptoms, such as excessive bleeding or signs of infection, is crucial during the recovery period. Patients are generally advised to avoid strenuous activities and sexual intercourse for a specified period to allow for proper healing. Follow-up appointments may be scheduled to assess the effectiveness of the procedure and to monitor the patient's recovery.

Short Descr ENDOMETR ABLATE THERMAL
Medium Descr ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID
Long Descr Endometrial ablation, thermal, without hysteroscopic guidance
Status Code Active Code
Global Days 010 - Minor Procedure
PC/TC Indicator (26, TC) 0 - Physician Service Code
Multiple Procedures (51) 2 - Standard payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 1 - Statutory payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 2 - Co-surgeons permitted and no documentation required if the two- specialty requirement is met.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Surgical procedure on ASC list in CY 2007; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P5E - Ambulatory procedures - other
MUE 1
CCS Clinical Classification 125 - Other excision of cervix and uterus
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
GC This service has been performed in part by a resident under the direction of a teaching physician
Date
Action
Notes
2011-01-01 Changed Short description changed.
2001-01-01 Added First appearance in code book in 2001.
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