Urology Coding Alert
Check Similar Open Procedures for Unlisted Benchmarking
Question: My surgeon performed an excision of a transplant ureter and a pyelovesicostomy. I’m thinking that maybe I will need to use an unlisted code, like 53899 for the pyelovesicostomy, but I’m not sure to what code(s) to benchmark it. Can you help?
Answer: You are correct that there is no exact code for the procedure your urologist performed. You should indeed us 53899 (Unlisted procedure, urinary system).
Benchmark this procedure to the nearest similar open procedure, which is 50750 (Ureterocalycostomy, anastomosis of ureter to renal calyx).
Pointer: Remember, when using an unlisted code, you will need to be prepared to provide the payer with a detailed operative report as well as providing a covering letter explaining in layman’s terms the nature of the procedure, possible complications, potential post-operative global period, as well as the benchmarked CPT® code of a procedure similar to what you did, and the fee you will be charging.
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Urology Coding Alert
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