Urology Coding Alert

Most notably for urologists, CPT 2000 includes laparoscopy as a separate procedure under urology for the first time. Coming into effect on Jan. 1, 2000, 14 new codes have been added for laparoscopy of the kidney, ureter, bladder, testes and spermatic cord.

CPT 2000 further states that surgical laparoscopic procedures performed by a urologistalways includes diagnostic laparoscopy. To report a diagnostic laparoscopy (peritoneoscopy) (separate procedure), use 49320. CPT codes 1999 required urologists to use 56300 (laparoscopy [peritoneoscopy], diagnostic: [separate procedure]), which has been deleted and replaced by 49320 (laparoscopy, surgical, abdomen, peritoneum, and omentum; diagnostic, with or without collection of specimen[s] by brushing or washing [separate procedure]).

Although the CPT 2000 laparoscopy codes do not refer to entirely new procedures, all are new codes that clarify the specific type of laparoscopy performed.

1. Kidney: The majority of the new laparoscopy codes apply to a kidney laparoscopy, and vary according to the specific treatment and/or procedure used:

50541: laparoscopy, surgical, ablation of renal cysts

50544: pyeloplasty

50546: nephrectomy

50547: donor nephrectomy from living donor (excluding preparation and maintenance of allograft)

50548: laparoscopically assisted nephroureterectomy

50549: unlisted laparoscopy procedure, renal

2. Ureter:

50945: laparoscopy, surgical, ureterolithotomy

3. Bladder:

51990: laparoscopy, surgical, urethral suspension for stress incontinence

51992: sling operation for stress incontinence (eg. fascia or synthetic)

4. Testis:

54690: laparoscopy, surgical, orchiectomy (formally 56318)

54692: orchiopexy for intra-abdominal testis

54699: unlisted laparoscopy procedure, testis

5. Spermatic Cord:

55550: laparoscopy, surgical, with ligation of spermatic veins for variocele (previously 56320)

55559: unlisted laparoscopy procedure, spermatic cord

These new codes reflect urologists increasing use of laparoscopy as a less intrusive procedure, says Susan Calloway Stradley, CPC, CCS-P, an independent reimbursement and coding consultant in North Augusta, SC. These changes show that Medicare is addressing new technologies and techniques. They also simplify coding because all the procedures have their own code, which includes a better definition of the value of the procedure