Urology Coding Alert

Question:What is the difference between a neobladder and ileal conduit?For an ileal conduit I bill CPT 50820 . Would I choose the same code for construction of a neobladder?Washington SubscriberAnswer:An ileal conduit is a 'conduit' or drainage tube that does not store urine and is made from a segment of small bowel (called the ileum). The ureters are anastomosed to the conduit and drain urine into this bowl segment. The conduit continuously drains urine into a receptacle placed on the skin. A ileal conduit is constructed to avoid using ureterocutaneous anastomoses that are prone to stricture formation and obstruction. An ileal conduit's cutaneous stoma (attachment to an opening in the skin) is less likely to contract or become obstructed. In contrast, a neobladder is usually a storage continent device or 'bladder.' The neobladder is usually composed from both large and small bowel. As compared to an ileal conduit this stores urine [...]