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Urology Coding Alert

You Be the Coder:

Nephrectomy

Published on Mon Jul 01, 2002

Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.
Question: How should we code for a patient who had an extracorporeal shock wave lithotripsy (ESWL) and needed a nephrectomy two weeks later? Texas Subscriber
Answer: You should report the ESWL with CPT 50590 (Lithotripsy, extracorporeal shock wave). If the nephrectomy constitutes treatment of a complication such as uncontrolled bleeding (599.89, Other specified disorders of urinary tract) or a renal abscess (590.2, Infections of kidney; renal and perinephric abscess) secondary to the shock wave, you should code 50220 (Nephrectomy, including partial ureterectomy, any open approach including rib resection) with modifier -78 (Return to the operating room for a related procedure during the postoperative period) appended. If the nephrectomy is treatment for an unrelated problem, report 50220-79 (Unrelated procedure or service by the same physician during the postoperative period).
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