In simple words: Deep endometriosis is a condition where tissue similar to the uterine lining grows deeply within the uterine wall or nearby areas. This can cause pain, heavy periods, and problems getting pregnant.

Deep endometriosis of the uterus refers to the presence of endometrial-like tissue in the uterine wall or surrounding structures, extending beyond the superficial layers.This condition is characterized by the growth of endometrial tissue outside of the uterine cavity, often involving deeper infiltration into the myometrium (uterine muscle) or adjacent pelvic organs.

Example 1: A 35-year-old woman presents with severe dysmenorrhea (painful menstruation), deep dyspareunia (painful intercourse), and infertility.A pelvic ultrasound and MRI reveal deep infiltrating endometriosis affecting the uterosacral ligaments. This necessitates laparoscopic surgery to excise the endometriotic implants., A 40-year-old woman complains of chronic pelvic pain and heavy menstrual bleeding.Laparoscopic examination reveals deep endometriosis involving the posterior uterine wall and rectum, requiring surgical resection and potential bowel repair., A 28-year-old woman with a history of infertility undergoes a diagnostic laparoscopy, which identifies deep endometriosis affecting the ovaries and fallopian tubes.This warrants further evaluation and management including assisted reproductive technology (ART).

Complete history and physical examination, including documentation of symptoms (pelvic pain, dysmenorrhea, dyspareunia, infertility), imaging studies (ultrasound, MRI), and surgical findings (if applicable).Preoperative and postoperative notes are essential. Laboratory results, including CA-125 levels, are sometimes indicated.

** Deep endometriosis is a complex condition requiring detailed clinical documentation to justify the code assignment. It's essential to differentiate it from other forms of endometriosis and adenomyosis.