Urology Coding Alert

Question:

I would greatly appreciate input on the proper coding of the surgery below:

• Robotic cystoprostatectomy
  
• Robotic BPLD
  
• Open ileal conduit.
  

The robot is undocked and an incision is made to perform the ileal conduit. The tacked ureters are found and the conduit is created. I should also mention the 50820 for the open ileal conduit allows a 50 modifier when performed bilaterally, as it is in this case. How should I code this?

Texas Subscriber

Answer: You should report the following:

• 51999 (Unlisted laparoscopy procedure, bladder) benchmarked to 51570 (Cystectomy, complete; [separate procedure]) for the robotic cystectomy
  
• 55866 (Laparoscopy, surgical prostatectomy, retropubic radical, including nerve sparing, includes robotic assistance, when performed) for the radical prostatectomy
  
• 38571 (Laparoscopy, surgical; with bilateral total pelvic lymphadenectomy) for the node dissection
  
• 50820-50 (Ureteroileal conduit [ileal bladder], including intestine anastomosis [Bricker operation]; bilateral procedure) for the open ileal conduit with bilateral ureteroenterostomies, implantation of both ureters into the ileal conduit.