Urology Coding Alert

Reader Question:

Sometimes Multiple Unlisted Codes are the Only Option

Published on Wed Oct 10, 2012

Question: My physician did the following:

Laparoscopic ureterolysis
Laparoscopic excision of ureteral stricture
Laparoscopic ureteroureterostomy
Laparoscopic stone basket extraction
Laparoscopic pyelolithotomy
Laparoscopic kidney stone removal.

With these procedures all being done via a laparoscopic approach I am having a hard time finding codes. I am sure some of them are going to be unlisted, but I didn't want to skip over any that might have codes that I just can't find. What codes should I be reporting?

Indiana Subscriber

Answer: Unfortunately, there are no specific CPT® codes for the laparoscopic procedures your urologist performed. Use the following codes:

50549 (Unlisted laparoscopy procedure, renal) for the kidney stone procedures
50949 (Unlisted laparoscopy procedure, ureter) for the ureteral procedures.

You will need to submit a detailed operative report and an explanatory covering letter. Also bench mark the unlisted kidney and ureteral laparoscopic procedures to the corresponding open procedures:

50130 -- Pyelolithotomy with removal of..."kidney"...calculus --(pyelolithotomy,...)
50715 -- Ureterolysis, with or without repositioning of ureter for retroperitoneal fibrosis
50700 -- Ureteroplasty, plastic operation on ureter (eg, stricture).

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