Urology Coding Alert

Question: A patient has an ileal conduit. He developed a ureterointestinal stricture, so the urologist performed a ureteral reimplant. He also has a parastomal hernia. I was going to use 50800 for the reimplant but what code would I use for the peristomal hernia repair?

Iowa Subscriber

Answer: Your code choice for the re-implantation of the ureter is correct. You should report 50800 (Ureteroenterostomy, direct anastomosis of ureter to intestine) for that procedure.

For the hernia repair, you may code the parastomal hernia repair several different ways depending on the clinical circumstances.

Here's how: If the urologist repaired the parastomal hernia without a revision of the ileal conduit stoma, this would represent an incisional hernia repair. In that case, you should use one of the incisional hernia repair codes 49560-49566 (Repair ... incisional or ventral hernia ...). However, if the urologist also revised the conduit stoma at the same time that he repaired the parastomal hernia, you should then report 50728 (Revision of urinarycutaneous anastomosis [any type urostomy]; with repair of fascial defect and hernia).