# Repair of transected ureter...HELP!



## sylmedtrans@msn.com (Sep 14, 2017)

Can someone help me with this op note?  It was billed out as 50760 but was denied.  I've been looking trying to find another CPT code, but I can't find anything that seems to match what was did.  I'm still in school and will be taking my CPC next month.  I work in charge entry and I'm trying to get this correct and billed out.  Thanks in advance for any help/direction you can give me!!

PREOPERATIVE DIAGNOSIS:  TRANSECTED URETER.

POSTOPERATIVE DIAGNOSIS:  TRANSECTED URETER

PROCEDURE:   INTRAOPERATIVE CONSULTATION AND A URETERAL REPAIR.

HISTORY OF PRESENT ILLNESS:  ______ who was undergoing a 
colectomy by _______ and there was an inadvertent transection of the ureter.  This was 
visualized immediately by _______ since he was able to see the stent.  Prior to my 
entering the surgical field, I asked him to go ahead and remove the colon and this was done.

DESCRIPTION OF PROCEDURE:  After I scrubbed in, the proximal end of the ureter was 
identified and the stent, which was approximately 5 cm above the cut portion of the ureter 
was transfixed with a 4-0 Vicryl so it would not migrate any further up.  The distal ureter 
was also identified because it had a stent poking out from it and it was dissected free from
the surrounding tissues very carefully with a right angle and tenotomy scissors and Bovie.  
The proximal stent was then grasped using Gerald forceps going up through the ureter 
grasping it.  It was removed without difficulty.  A 6-French 24 double-J was then passed 
proximally and distally without too much difficulty even though I did not have an 
intraoperative stent with closed ends.  4-0 Vicryl was then used to reanastomose the ureter 
in an interrupted fashion and approximately 8 sutures were placed to the reapproximation.  
There was good oozing of blood flow from the edges of the ureter.  After placing all the 
Vicryl sutures and making sure the back wall and the front wall were completely 
reapproximated.  All ties were cut, the ureter was reoriented in an orthotopic fashion.  We 
were satisfied with the repair and I mentioned to _______ to make sure to leave a drain
in the periureteral space to make sure that any drainage would be captured.  I told him that
I would remove the stent in 6-8 weeks.  Case was then turned back over to _______.


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## cgaston (Sep 14, 2017)

Since the ureter was reanastomosed with sutures how about *50900*: _Ureterorrhaphy _?


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## sylmedtrans@msn.com (Sep 14, 2017)

Thank you!!!  I think I've read every code in the Urinary section trying to find the best one.


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