Urology Coding Alert

Question: We performed a robotic assisted laparoscopic distal left ureterectomy, psoas hitch of the bladder, and left ureteroneocystostomy with stent placement. I think both 50948 and 50650 are correct based on our physician’s documentation, but if I’m looking at things correctly it seems like I can only bill 50948 and cannot unbundle 50650. Is that correct, or am I missing something?

Nevada Subscriber

Answer: You are correct in your thinking. For the scenario you describe, report 50948 (Laparoscopy, surgical; ureteroneocystostomy without cystoscopy and ureteral stent placement) for the laparoscopic reimplantation of the ureter into the bladder. This CPT^® code includes the laparoscopic psoas hitch, excision of the lower ureter, and the intraoperative stent placement. Therefore, you cannot separately report 50650 (Ureterectomy, with bladder cuff [separate procedure]). Submitting only code 50948 covers all services that your physician provided.