Inpatient Facility Coding & Compliance Alert

Answer: There are separate codes for partial bladder removal. You need to understand the fine difference between each.

 

Code 50825 stands for Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty).

 

Koch pouch relates to a 70 cm segment of ileum being reformed into a peristaltic pouch with 2 nipple valves. Camey enterocystoplasty uses a 35-40 cm segment of intact ileum anastomosed to the urethral stump to create a continent intestinal reservoir. Ureters are sutured into a 3 to 4 cm trough in the bowel mucosa in each limb of the reservoir to create effective antireflux flap valves.

 

You should report 50820 (Ureteroileal conduit [ileal bladder], including intestine anastomosis [Bricker operation]) when the provider performs a urinary diversion that uses the terminal ileum, small bowel, to form a conduit or passage way leading out of the body  through a specially designed opening from the abdomen usually into a urinary collection device. 

 

If the physician uses a small and/or large bowel to form a reservoir or pouch rather than a conduit into which he reimplants the ureters, then you should submit code 50825 (Continent diversion, including intestine anastomosis using any segment of small and/or large intestine [Kock pouch or Camey enterocystoplasty]). The provider constructs its opening to the outside through the urethra so that it remains continent. This requires periodic catheterization to empty the pouch. In contradistinction to the ileal conduit, this intestinally constructed pouch remains a continent, non-leaking diversion or reservoir for storage of urine.