Urology Coding Alert

Question: To describe lap hand-assisted radical nephrectomy, do we use the laparoscopic procedure code for radical nephrectomy (CPT 50545 ) or would an unlisted procedure code be better?

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Answer: You should report 50545 (Laparoscopy, surgical; radical nephrectomy [includes removal of Gerota's fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy]) for a laparoscopic hand-assisted radical nephrectomy.

Don't miss: A "hand-assisted" procedure simply means that your urologist uses his hand as another portal for the procedure. This method should not change your coding. Therefore, you would code a hand-assisted radical laparoscopic nephrectomy with 50545 just as you would a non-hand-assisted procedure. Don't be tempted to append modifier 22 (Increased procedural services) for the hand-assisted procedure or to report any additional codes. When a surgeon performs a hand-assisted procedure, payers consider the hand in the wound an extra portal site, which does not necessitate or warrant an additional CPT code or modifier.