# Robotic Assisted Laparoscopic Pyeloplasty



## JESSHEATH

Looking for a CPT code to best define a robotic assisted laparoscopic pyeloplasty with stone abstraction performed by a Urologist. I find CPT 50544, but I am not sure that that includes the stone abstraction or the robotic assist.  Can anyone advise on alternative CPT's for this procedure


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## deynaw

use the S2900 for the robotic assist after listing the primary procedure..pretty sure no one will pay on it..but that would be the code


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## mmorningstarcpc

You may want to check with the robotic manufacturer.  They many times have some coding guidance to help providers.  You will want to validate what they say with your current resources though.  This can be really valuable information sometimes.  Occasionally I have found some to be outdated, so check your current books also.  Unfortunately for many procedures, right now you just code the regular procedure, you get nothing else for the robotic use.  Just FYI, there are robotic codes now in the inpatient setting.


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## indian coder

xgggg


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## Kelly_Mayumi

I'm interested to know how this was billed, if it is remembered since it was so long ago?


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## msepulveda

JESSHEATH said:


> Looking for a CPT code to best define a robotic assisted laparoscopic pyeloplasty with stone abstraction performed by a Urologist. I find CPT 50544, but I am not sure that that includes the stone abstraction or the robotic assist.  Can anyone advise on alternative CPT's for this procedure


the stent is included in the description of CPT code 50544

The physician performs a pyeloplasty via a laparoscopic approach. Pyeloplasty is a reconstructive operation performed to treat blockage or narrowing of the ureter at the ureteropelvic junction (UPJ). Small portal incisions are made and pneumoperitoneum is achieved by insufflating the abdomen with air. Trocars are placed and the laparoscope is inserted through an umbilical port. The lateral line of Toldt is identified and incised. The peritoneum over the kidney is mobilized and the anterior surface of the kidney is visualized. The colon is mobilized and rolled medially. The ureter and surrounding vascular structures are identified. The ureter is dissected free of surrounding tissue, taking care to ensure adequate fat is maintained around the ureter. The ureteropelvic junction (UPJ) is exposed and the lower pole of the kidney is mobilized. The UPJ is isolated and any aberrant blood vessels impinging on the UPJ are identified and dissected free. The obstructed segment of the UPJ is then dissected free and excised. The renal pelvis is trimmed as needed and the ureteral stump is examined and spatulated. A stent is placed through the ureter into the bladder. The posterior wall of the UPJ is anastomosed, followed by closure of the renal pelvis. The proximal end of the ureteral stent is then placed in the renal pelvis and the anterior UPJ incision is closed. A drain may be placed. The surgical site is inspected, bleeding is controlled, surgical instruments are removed, and incisions are closed.


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## msepulveda

JESSHEATH said:


> Looking for a CPT code to best define a robotic assisted laparoscopic pyeloplasty with stone abstraction performed by a Urologist. I find CPT 50544, but I am not sure that that includes the stone abstraction or the robotic assist.  Can anyone advise on alternative CPT's for this procedure


There is no code for the stone extraction so I would use an unlisted 53899


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