Wiki Ureterolysis CPT 50715

[mybarra1970]

Anyone have any suggestions on how we can get this procedure paid when billed in conjunction with a colectomy we are using a 59 modifier getting denials and what type of documentation we should be including in the op report to get this paid. Thanks in advance.

 

[csperoni]

Ureterolysis is typically included with other pelvic surgeries.
The only ureterolysis codes all specify the medical reason for performing:
Ovarian Vein Syndrome 50722
Retrocaval Ureter 50725
Retroperitoneal Fibrosis 50715

50715 is payable only if it does meet -59 requirements AND for a diagnosis of retroperitoneal fibrosis (N13.5) which is fairly rare. The op report should specify the retroperitoneal fibrosis (may also be listed as Ormond's disease).
If the carrier does not want to recognize this, I suppose your other alternative is the colectomy code (44150-44151) with -22 modifier and an appeal letter explaining the additional work, time & skill required.

Hope this helps!