Urology Coding Alert

Question: Would you please explain the difference between codes 50820 and 50825?


California Subscriber

Answer: You should report 50820 (Ureteroileal conduit [ileal bladder], including intestine anastomosis [Bricker operation]) when the urologist performs a urinary diversion that uses the terminal ileum, small bowel, to form a conduit or passage way leading out of the body usually into a urinary collection device. The main reason your urologist uses the bowel in this case is to have an outflow tract in which to place or reimplant the ureters.

If the physician uses a small and/or large bowel to form a reservoir or pouch rather than a conduit into which he reimplants the ureters, then you should submit code 50825 (Continent diversion, including intestine anastomosis using any segment of small and/or large intestine [Kock pouch or Carney enterocystoplasty]). The urologist constructs its opening to the outside so that it remains continent. This requires periodic catheterization to empty the pouch. In contradistinction to the above ileal conduit, this intestinally constructed pouch remains a continent, non-leaking diversion or reservoir for storage of urine.