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Urology Coding Alert

Reader Questions:

Use Node Dissection to Decide Ileal Loop Code

Published on Wed Apr 06, 2005

Question: What should I code for a radical cystoprostatectomy and ileal conduit diversion? At first, I thought of 55845, but now I do not think that I am correct.

Nebraska Subscriber Answer: The first part of this surgery was the cystectomy with ileal loop. If the urologist did not perform a bilateral node dissection along with the cystectomy, report 51590 (Cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including intestine anastomosis). If he did perform a bilateral node dissection, report 51595 (... with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes).
 
For the prostatectomy, report 55840 (Prostatectomy, retropubic radical, with or without nerve sparing). If the urologist also placed bilateral ureteral stents, report 50605-50 (Ureterotomy for insertion of indwelling stent, all types; bilateral procedure).
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