Urology Coding Alert

Question: One of my doctors did a robot assisted laparoscopic pyeloplasty (CPT 50544 ) and he removed several stones that were in the renal pelvis at the same time. He gave me the code 50065 which to my understanding is done open and not laparoscopic. There isn't a CPT® code for laparoscopic removal of renal pelvic stones, so how should I report this procedure?

South Carolina Subscriber

Answer: You are correct. There is no CPT® code for a laparoscopic removal of a renal pelvic stone. Therefore, you'll need to use the unlisted code for the urinary system -- 53899 (Unlisted procedure, urinary system). Benchmark this code to the open code 50130 (Pyelotomy; with removal of calculus [pyelolithotomy, pelviolithotomy, including coagulum pyelolithotomy]). You may be asked for detailed  documentation via an operative report and covering letter.

Remember: First bill for the laparoscopic pyeloplasty with CPT® code 50544 (Laparoscopy, surgical, pyeloplasty).