Urology Coding Alert
Cystectomy
Question: When I bill 51595 and 43830, the 43830 is denied as being part of 51595. I looked in the (NCCI)National Correct Coding Manual and cannot find anything that backs this up.
Kansas Subscriber
Answer: Code 43830 (gastrostomy, open; without construction of gastric tube [e.g., Stamm procedure] [separate procedure]) may have been denied when billed with 51595 (cystectomy, complete, with ureteroileal conduit or sigmoid bladder, including bowel anastomosis; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes) because 43830 is defined as a separate procedure. When a gastrostomy is performed as an incidental part of another, more invasive procedure, it should not be separately reported. But if the gastrostomy is not an integral part of the other procedure, it can be reported separately. Use modifier -59 (distinct procedural service) if the nonintegral procedure is bundled into the more extensive procedure.
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