Advanced Search

Urology Coding Alert

Reader Question:

Open Up Billing Opportunities With Nephrectomy

Published on Mon Apr 12, 2004

Question: Our surgeon performed a hand-assisted laparoscopic radical nephrectomy and finished with an open distal completion ureterectomy. Should I code this as an open radical nephrectomy? Do I need to append modifier -22 (Unusual procedural services)?

Pennsylvania Subscriber Answer: It sounds as if your urologist performed a total nephroureterectomy via a laparoscopic and open procedure. If so, code this procedure as 50548 (Laparoscopy, surgical; nephrectomy with total ureterectomy) for the laparoscopic portion of the procedure, and 50650-51 (Ureterectomy, with bladder cuff [separate procedure]; multiple procedures) for the open distal ureterectomy and removal of a bladder cuff (if performed).

If he also did an adrenalectomy in this particular case, use 60650-51 (Laparoscopy, surgical, with adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal; multiple procedures), because it is not included in the above laparoscopic nephrectomy.
You’ve reached your limit of free articles. Already a subscriber? Log in.
Not a subscriber? Subscribe today to continue reading this article. Plus, you’ll get:
  • Simple explanations of current healthcare regulations and payer programs
  • Real-world reporting scenarios solved by our expert coders
  • Industry news, such as MAC and RAC activities, the OIG Work Plan, and CERT reports
  • Instant access to every article ever published in your eNewsletter
  • 6 annual AAPC-approved CEUs*
  • The latest updates for CPT®, ICD-10-CM, HCPCS Level II, NCCI edits, modifiers, compliance, technology, practice management, and more
*CEUs available with select eNewsletters.

Other Articles in this issue of

Urology Coding Alert

View All