Urology Coding Alert

Question: The urologist performed a laparoscopic mobilization of a kidney but then did an open pyeloplasty. How should I report this converted procedure?Answer: For most payers you should report the code for the open procedure alone because your urologist converted from a laparoscopic surgery to an open procedure. In your case, report 50400 (Pyeloplasty [Foley Y-pyeloplasty], plastic operation on renal pelvis, with or without plastic operation on ureter, nephropexy, nephrostomy, pyelostomy, or ureteral splinting; simple). Your diagnosis codes would include 753.21 (Congenital obstruction of ureteropelvic junction) and V64.41 (Laparoscopic surgical procedure converted to open procedure).Alternative: A few private or commercial payers may reimburse you for both procedures " the open and the laparoscopic. In those cases, code the case as follows: 50400 for the open pyeloplasty50544 (Laparoscopy ,surgical, pyeloplasty) for the laparoscopic kidney mobilizationAppend modifier 52 (Reduced services) to 50544 since your urologist didn't complete the procedureAppend modifier 59 (Distinct [...]