Urology Coding Alert

Question: Our doctor removed a transplanted kidney (CPT 50370 ) due to rejection and also removed the native kidney (50220) due to a possible malignant renal mass. Both nephrectomies were performed with separate incisions and closures. We will be using modifier 22 due to scar tissue from the previous surgery. Code 50370 has an MUE of 1 and 50220 is bundled with no modifier allowed, per CCI. Code 50220 has an MUE of 2. For a Medicare patient, would it be appropriate to code 50220 and 50220-59? Oklahoma Subscriber Answer: You should report 50370 (Removal of transplanted renal allograft) for the transplanted kidney removal. Then, report 50220 (Nephrectomy, including partial ureterectomy, any open approach including rib resection) for the simple nephrectomy your urologist also performed. Append modifier 59 (Distinct procedural service) to 50220 to indicate the separate nature of the procedures. Watch out: The Correct Coding Initiative (CCI) bundles 50220 [...]