Urology Coding Alert
Redocking the Robot Doesn't Equal Separate Codes
Question: I am having a disagreement with one of my doctors, regarding 50548. When performed robotically, does 50548 include removal of the bladder cuff with closure of the bladder? My physician will mobilize the kidney and most of the ureter, undock the robot to reposition the patient, redock the robot, and resume excising the distal ureter, bladder cuff and close the bladder. He wants to use 50545 and 51999. I want to use 50548. Who is correct?
Ohio Subscriber
Answer: You are correct, in this scenario. The proper code would be 50548 (Laparoscopy, surgical; nephrectomy with total ureterectomy). This code includes a complete robotic total nephroureterectomy with excision of the distal ureter and a bladder cuff and bladder closure, all performed robotically including redocking the robot.
Reporting a radical nephrectomy (50545, Laparoscopy, surgical; radical nephrectomy [includes removal of Gerota’s fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy]) and the unlisted code 51999 (Unlisted laparoscopy procedure, bladder) would be incorrect. Reporting those two codes is basically trying to unbundle a procedure that is already accurately described by a more complete code: 50548.
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