CPT® Code 59140

The CPT® Code 59140 refers to the surgical treatment of a cervical ectopic pregnancy through evacuation. A cervical ectopic pregnancy occurs when a fertilized ovum implants within the cervical stricture, specifically below the internal os. This abnormal implantation leads to the growth of the trophoblast, which invades the endocervix, resulting in the pregnancy developing within the fibrous cervical canal. Patients with this condition often present with symptoms such as vaginal bleeding, which can be a significant concern due to the potential for life-threatening hemorrhage. In many cases, conservative treatment options are limited, and a hysterectomy may be necessary to manage the situation effectively. However, when conservative management is feasible, it typically involves a combination of systemic chemotherapy and cervical evacuation, which may include curettage. The initial treatment may consist of administering multiple doses of methotrexate and leucovorin over a four-day period. If complications arise, such as hemorrhage, ligation of the cervical arteries may be performed to control bleeding. The evacuation of the products of conception from the cervical canal can be achieved through sharp curettage or suction curettage. To manage bleeding, techniques such as cervical tamponade using a balloon catheter or cervical stay sutures may be employed. Additionally, local injections of vasoconstrictors and cervical cerclage may be utilized, followed by cervical curettage and evacuation to ensure the safety and health of the patient.