Urology Coding Alert

Question: Our coders are under the impression that we cannot use “open” surgery codes for robotic or laparoscopic procedures. For example, if the surgeon does a robotic ureteroenterostomy (a procedure without a specific CPT^® code), our coders say we need to use an unlisted code such as 50949 instead of the open procedure code 50800. Is 50800 appropriate if the procedure is performed robotically?

Minnesota Subscriber

Answer: Laparoscopic procedures should never be billed with an open procedure code. Instead,   report laparoscopic procedures with a descriptive laparoscopic code or, if not available as in this case, an unlisted laparoscopic code for the particular organ.

In the example you describe, there is no specific laparoscopic CPT^® code for the ureteral implantation into the intestine. Therefore, your colleagues are correct: report 50949 (Unlisted laparoscopy procedure, ureter) instead of 50800 (Ureteroenterostomy, direct anastomosis of ureter to intestine) for this clinical situation. However, benchmark the open procedure code 50800 as a similar procedure to the unlisted laparoscopic/robotic procedure performed for reimbursement purposes.