A dilation and curettage, commonly referred to as a D&C, is a procedure that involves removing some of the tissue from within the uterus. Women may need to undergo a D&C for a number of reasons, including heavy menstrual bleeding or after an abortion or miscarriage has occurred. It can also be done to diagnose certain conditions. In some cases, a D&C may be covered by Medicare; however, the procedure must be deemed medically necessary and the surgeon you select must accept Medicare insurance and be approved by your Medicare insurance policy.

What is a Dilation and Curettage?
A D&C requires the woman to be placed under anesthesia. This procedure can be done under general anesthesia, light sedation, local, or regional anesthesia may be used. The exact type of anesthesia used depends on the specific surgeon’s preferences and will be based on the health and needs of the individual patient.

During the D&C, the physician will insert a speculum into the vagina in order to see and access the cervix. Rods are then inserted through the cervix, with each one slightly larger than the previous one. This allows the cervix to dilate so that the physician can remove the excess tissue inside the uterus. After the cervix is adequately dilated, the rods are removed and a spoon-shaped device with a sharp edge or a suction device is inserted into the uterus. The excess uterine tissue is then removed and suctioned out of the body.

After the procedure, the patient will stay in recovery for a few hours to be monitored for heavy bleeding or any other complications that may arise. This allows the anesthesia to wear off as well. After the procedure, mild cramping is usual, as is light bleeding. The recovery time is only a few days.

Why is a D&C Done?

D&Cs can be done to diagnose a health condition or to treat one. If done for diagnostic purposes, a sample of the endometrial lining is taken so that it can be tested. This may be due to abnormal or heavy uterine bleeding, bleeding after menopause, or the discovery of abnormal cells during a screening for cervical cancer. Diagnostic tests can look for a variety of issues, including uterine cancer, polyps, or endometrial hyperplasia, which occurs when the uterine tissue lining becomes too thick.

A D&C can also be done following an abortion or miscarriage to remove a larger amount of uterine tissue than just a small sample for diagnostic reasons. After a miscarriage or abortion, uterine tissue may still be left that must be removed to lower the risk for infection or excessive bleeding.

This surgery may also be required after a delivery if some of the placenta remains in the uterus after birth. If a molar pregnancy occurs, in which a tumor grows in the uterus instead of a fetus, a D&C can remove the tumor. This procedure can also be done to remove polyps on the cervix or in the uterus.

Does Medicare Coverage Include D&C Procedures?
If your physician deems a D&C medically necessary, Medicare may help cover the costs. It is important that you select a surgeon that is approved by Medicare and that accepts Medicare insurance. If you require a D&C following or during an inpatient hospital stay, Medicare Part A will cover the costs as long as you have met your deductible payments.

If you are seeking the procedure in an outpatient setting, Medicare Part B may cover the costs of the procedure, but you may be required to pay your premium payment, deductible, and cost-sharing responsibilities.

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