# "RADICAL" Nephrectomy vs Nephrectomy



## bclark003 (Oct 9, 2012)

To bill a 50545 does the provider have to remove *ALL* the of the following: Gerota's fascia, regional lymph nodes & adrenal gland?  If he removes just the adrenal gland is it still a 50545 or would you bill instead a 50546 with adrenalectomy??   My provider feels any time the nephrectomy is done for cancer it is a "radical".  Thanks!!


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## svt96cobra (Oct 10, 2012)

"RADICAL" refers to removal of entire kidney. It does include the fascia, fatty tissue. etc, but does not necessarily mean that they have to be removed. The 50546 would be appropriate if the entire kidney and part of the ureter is removed. So I would agree with the provider. When removed for cancer, they are removing the "entire" kidney and not part of it, it would be 50546 (if done lapi).....Hope this helps!

Brandy


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## Kelly_Mayumi (Oct 16, 2012)

The AUA has a stance, when a radical nephrectomy is preformed and the adrenal is left behind, that is still 50545.  I have not seen their stance if lymph nodes are not removed.  I have seen many coding articles specify if lymph nodes are not removed use 50545, 52 to report the service.  Dr. Michael Ferragamo is presenting an AAPC webinar on Advanced Urological Coding and I hope he covers this topic.


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## vandrews (Mar 25, 2013)

Did anyone get a clear understanding about radical vs simple nephrectomy?  We also question if the reg lymph nodes are not removed should we be coding radical or simple???  

Thanks!


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