Urology Coding Alert

Reader Question:

Nephrectomy With Resection

Question: A physician performed a right nephrectomy with a resection of the ileal conduit urinary diversion. How should we code the resection? New York Subscriber Answer: Unfortunately, there is no CPT code for excision or resection of an ileal conduit. Therefore, you should use 44799 (Unlisted procedure, intestine). As with all unlisted-procedure codes, you should submit this as a paper claim instead of electronically. In addition, you should include a detailed operative report as well as a simple, short explanatory note in layman's terms regarding the procedure. Do not be tempted to use 44620 (Closure of enterostomy, large or small intestine) to avoid the unlisted-procedure code; it is not accurate. You should also estimate and supply a reasonable fee based on a procedure similar in work, skill, risk to the patient and follow-up time.  
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