Wiki Simple prostatectomy code?? Please help!


Puyallup, WA
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What would the code for a simple laparoscopic prostatectomy be?? When I've researched it I can't find much. What I did find seems to say that you would bill an unlisted code?? I'm really not sure what else it would be. Anyone have any advice?? I'm being asked what to use by one of our providers, and want to get some advice before I answer. Thank you!
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I need help finding a code for a laparoscopic simple prostatectomy. There is only one lap prostatectomy code, but it's for a radical. I'm assuming that I would use an unlisted code such as 55899, but wanted some advise on if that's right or not. Since this is the first time I've come across this. See below for the operative report. Thank you for any help you can provide. I really appreciate it!

PREOPERATIVE DIAGNOSIS: Benign prostatic hypertrophy with lower urinary tract symptoms, gross hematuria.
POSTOPERATIVE DIAGNOSIS: Benign prostatic hypertrophy with lower urinary tract symptoms, gross hematuria.
PROCEDURE PERFORMED: Robotically assisted laparoscopic simple prostatectomy; placement of abdominal drain.
FINDINGS: Large prostate fixed in place at the bladder neck and left lobe consistent with prior TURP procedures. Bilateral ureteral orifices identified and preserved throughout the case.
SPECIMENS: Prostate adenoma.
DRAINS: A 22 French 3-way Coude catheter and a 15 mm round JP drain.
INDICATIONS: This is a pleasant xxyear old male with benign prostatic hypertrophy with lower urinary tract symptoms secondary to a very large prostate and recurrent gross hematuria consistent with bleeding from the prostate. The decision was made for robotically assisted simple prostatectomy based on the size of the prostate and the patient's multiple prior endoscopic treatments for BPH. Risks and benefits of surgery were explained to the patient in detail and informed consent was obtained.

DESCRIPTION OF PROCEDURE: After informed consent was obtained, the patient was brought to the operating room. He was placed supine on the table. He underwent general anesthesia with endotracheal tube. Preoperative IV antibiotics were confirmed and a timeout was held. The patient was carefully padded and secured to the bed. He was prepped and draped in sterile surgical fashion. Mild fossa navicularis stricture disease was again encountered. This was dilated with a lubricated clamp. An 18 French Foley catheter was advanced into the patient's bladder and inflated with 10 mL of sterile water. Bupivacaine was injected at all port sites. A 1 cm vertical supraumbilical incision was made and upward traction placed on the wound. A Veress needle was inserted into the abdomen. A saline drop test demonstrated correct position. The peritoneum was insufflated to 15 mmHg. The Veress needle was removed, and a 0 degree laparoscopic lens within a 12 mm laparoscopic port was advanced into the abdomen under direct vision to ensure no injury to bowel or other intraabdominal structures. Abdominal exploration was performed laparoscopically. There were no adhesions identified. The remainder of the robotic ports were placed without incident. On the left, the port was placed 8 cm lateral to the umbilical port and a second port was placed 2 cm medial to the ASIS, both 8 mm ports. On the right, the right robotic arm port was placed 9 cm from the umbilical port. The assistant port, 12 mm, was placed 4 cm medial to the ASIS. Patient was placed in steep Trendelenburg and the robot was docked.

The bladder was mobilized by dissecting across the urachal attachments and bringing the bladder down. A portion of the periprostatic fat was dissected off the prostate to confirm the level of the bladder neck. The bladder was opened longitudinally. The bilateral ureteral orifices were identified. Incision was made below the level of the median lobe, being careful to protect the ureteral orifices. The dissection in this location was slow secondary to prior TURP procedures. Dissection then commenced along the plane between the prostatic capsule and adenoma first on the right. The plane was identified and the adenoma was carefully dissected off the capsule. A circumferential incision was made in the urothelium and the dissection continued. The prostate capsule was opened at this time by further advancing the vertical incision. Bleeding at the lateral edges of the capsule was controlled with bipolar. The urethra was divided anteriorly. The prostate adenoma was removed and the specimen placed in an Endo Catch bag. Near the apex of the adenoma on the left, there appeared to be a defect in the prostate capsule with venous sinus bleeding. This was closed with 3-0 V-Loc suture in a running fashion. A defect was also identified in the left lateral capsule corresponding to an area of difficult dissection during removal of the adenoma. This was closed with a 3-0 V-Loc suture in a running fashion. The posterior bladder urothelium was reapproximated to the posterior urethra using two running 3-0 V-Loc sutures.

The prostate was thoroughly irrigated, including the bladder, to remove all clot. The prostate capsule and bladder were closed using 3-0 V-Loc from each apex. These were run to the midline and tied. A second layer was closed using 2-0 Vicryl in a running fashion. A 22 French 3-way Coude catheter was inserted, and the balloon was inflated with 30 mL of sterile water. The catheter was then thoroughly irrigated; 180 mL total was instilled in the bladder, with no obvious leak noted. The pelvis was thoroughly irrigated. The robot was undocked. The patient was taken out of Trendelenburg. A 15 mm round JP drain was placed through the left fourth arm robotic port site and sutured in place using 2-0 nylon. The trocars were removed. The prostate was morcellated and the pieces brought out through the midline port site. The fascia was closed using #0 Vicryl in a running fashion.The dead space of all port sites was closed using 2-0 Vicryl. The skin was closed Dermabond. Bupivacaine was injected in all port sites. All instrument and sponge counts were correct prior to leaving the operating room. Continuous bladder irrigation was initiated. The patient was returned to supine position and transferred to the postanesthesia care unit after successful extubation.
I really don't see any other option than the unlisted. Any other takers? Don't forget your S code for robotic (I think its S2900).