Wiki Laparoscopic Ureterolysis CPT Coding Help

[melyrop1966@yahoo.com]

Hi All,
This is my first question to the group! I'm having difficulty with my GYN and Uro/Gyn providers billing for Ureterolysis. I have advised them 50715 is for an open procedure and there currently is no CPT code for a Laparoscopic Ureterolysis. Therfore we've been using 50949 - Unlisted but I'm doubting myself (attaching the operative report to the claim)
Case 1 - Uro/GYN
If a physician states he performed a Laparoscopic Ureterolysis during a Supracervical Hysterectomy and Bladder Sling & Ureterolysis. Would this be included due to the Physician stating "Bilateral Ureterolysis was done to the level of the insertion of the ureters into the bladder for easy identification and decreased chance of injury"

58542 - (Based on weight of the uterus)
57288-51 - Sling
50949 -Unlisted Lap procedure of the ureter????

Case 2 - Gyn

Physician performed Laparoscopic Ovarian Cystectomy, Excision of endometriosis, Retroperitenal space exploriation and Ureterolysis.

Would the ureterolysis be included as the physician perfomed the procedure in order to free up the ureter so the pelvic peritoneum could be free from the dissection from the ureter.

Thank You - Melissa

 

[bonzaibex]

Lysis work is typically included in the main procedure code and is not billable as a separate procedure. This has been true of pelvic LOA for some time, and CCI edits have recently been updated to include Enterolysis. I suspect Ureterolysis falls under the same bundling edits.

If the lysis represents significant extra work, adding significant extra time to the procedure, you can try billing the main procedure with a -22 modifier and all the documentation that goes with it.

Becky, CPC