Wiki Surgery

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RebeccaB

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Patient underwent laparoscopic radical cystectomy with ileal conduit diversion,extended lymph node dissection...uterus,cervix and anterior wall of vagina removed en bloc with specimen

Do we bill cystectomy and hysterectomy ?

Any help appreciated

Thanks
Rebecca
 
Without seeing the op note, this is hard to tell, but it sounds like a pelvic exenteration (CPT 51597). This code is for lower urinary tract malignancy. If a salpingo-oophorectomy is done at the same time, the AUA coding hotline recommended that we bill for that as well (CPT 58661), as it is not in the description of the pelvic exenteration. The AUA also stated that the ileal conduit is separately reportable with CPT 50820, but for commercial payers only. Medicare considers the ileal conduit inclusive to CPT 51597.

Hope this helps.

Drew Vinson
CPC
NW Urology
 
pelvic exenteration 51597 with ileal conduit 50820. Based on NCCI guidelines, if documentation supports, they are separately billable
 
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