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Urology Coding Alert

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Converted Nephrectomy

Published on Fri Dec 01, 2000

Question: Our urologist encountered problems while performing a laparoscopic nephrectomy, and had to switch to an open procedure. What is the correct way to code this?

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Test your coding knowledge. Determine how you would code this situation before looking at the box below for the answer.



Answer: If the surgery was planned as a laparoscopic nephrectomy, and due to complications was converted to an open procedure, you should bill for the laparoscopic and open procedure, with modifier -52 (reduced services) attached to the laparoscopic procedure. The laparoscopic procedure is coded 50545 (radical nephrectomy [includes removal of Gerotas fascia and surrounding fatty tissue, removal of regional lymph nodes, and adrenalectomy]), and the open procedure is coded 50230 (nephrectomy, including partial ureterectomy, any approach including rib resection; radical, with regional lymphadenectomy and/or vena caval thrombectomy).
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