Urology Coding Alert

Question: The patient's Mitrofanoff stoma had stenosed near the bladder end of the stoma. In short, the physician removed the stoma from the stenosed site, found another area of the bladder and did a re-anastomosis there. Can you suggest proper coding for this procedure?

Answer: You should consider this sort of bowl revision to be a partial redo of the procedure in question. In this case 50845 (Cutaneous appendico-vesicostomy) is likely the best code to use. You'll want to append modifier 52 (Reduced services) to indicate that the urologist did only a part of the full procedure and not the full Mitrofanoff procedure.

Remember: To ensure payment this will need a detailed operative report and an explanatory covering letter in layman's terms that explains what the physician actually did.