vNOTES Hysterectomy

Created Oct 2021


What procedure code is assigned for vNOTES (Vaginal Natural Orifice Transluminal Endoscopic Surgery) hysterectomy?

vNOTES is a minimally invasive technique using the natural body orifices to access the human body for surgery. The vNOTES hysterectomy technique involves a circular incision around the cervix, anterior and posterior colpotomy and transecting the sacro-uterine ligaments.  The vNOTES port is placed and access to the abdominal cavity is gained via the colpotomy and a pneumoperitoneum is created.  Laparoscopic instruments are then introduced and hysterectomy is performed, haemostasis checked, the vNOTES port and uterus are removed trans-vaginally, pneumoperitoneum deflated and the vaginal cuff closed.

We thought the best way to capture this new procedure would be to use 35750-00 [1269] Laparoscopic assisted vaginal hysterectomy (LAVH) and add free text to specify that it was using the vNOTES technique.

Does the NZCA agree with the procedure code suggested?


Yes. Based on the technique the most appropriate procedure code for vNOTES hysterectomy is code 35750-00 [1269] Laparoscopic assisted vaginal hysterectomy.  Free text is to be used to specify vNOTES hysterectomy.

As vNOTES is a new technique in performing a hysterectomy procedure, a coding query has been raised with the Independent Hospital Pricing Authority (IHPA) to confirm appropriate code assignment.

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