Wiki Coding Help Please

[dballard2004]

One of my urology providers has reached out to me for guidance on how to code for a very complex surgery he performed. What codes would be used for the following, please?

A retroperitoneal lymph node dissection, laparotomy, resection of retroperitoneal mass, appendectomy, bladder repair, bilateral ureterolysis.

This is unfortunately all the info I have at the moment.

Any ideas? Thanks.

 

[daniel]

Hi, there’s a lot of moving pieces here.

First, I’d mention retroperitoneal lymph node dissection is inclusive to 49203-49205 for resection of retroperitoneal mass. See CPT instructions under CPT 49203-49205 for this guidance.

You could add CPT 50715.50.59 for bilateral ureterolysis. But retroperitoneal fibrosis needs to be documented. Otherwise it’s inclusive.

As for the appendectomy, CPT 44950 is not allowed at all. Even with modifier 59.

I would guess the bladder repair is incidental to the procedure, 51860 is for injury. Is the bladder injured?
Hope this helps

 

[dballard2004]

Hi, there’s a lot of moving pieces here.

First, I’d mention retroperitoneal lymph node dissection is inclusive to 49203-49205 for resection of retroperitoneal mass. See CPT instructions under CPT 49203-49205 for this guidance.

You could add CPT 50715.50.59 for bilateral ureterolysis. But retroperitoneal fibrosis needs to be documented. Otherwise it’s inclusive.

As for the appendectomy, CPT 44950 is not allowed at all. Even with modifier 59.

I would guess the bladder repair is incidental to the procedure, 51860 is for injury. Is the bladder injured?
Hope this helps

Thanks so much! Very complicated I know!