How To Use CPT Code 50070

CPT 50070 describes a specific procedure known as nephrolithotomy, which is performed to remove kidney stones in patients with a congenital kidney abnormality. This article will provide an overview of CPT code 50070, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50070?

CPT 50070 is a code used to describe the procedure of nephrolithotomy, which involves the incision of the kidney to remove kidney stones. This procedure is specifically performed in patients who have a congenital kidney abnormality. It is important to note that CPT 50070 should only be used when the patient has a documented congenital kidney abnormality and the procedure is performed to address the complications caused by the kidney malformation.

2. Official Description

The official description of CPT code 50070 is: ‘Nephrolithotomy; complicated by congenital kidney abnormality.’

3. Procedure

1. The procedure begins with the patient being appropriately prepped and anesthetized.
2. The healthcare provider makes an incision in the patient’s back on the side of the affected kidney.
3. Soft tissues are dissected, and Gerota’s fascia, which is the fascia present just above the surrounding kidney space, is incised.
4. The provider then dissects the perirenal fat overlying the kidney.
5. A nephroscope, an instrument that allows visualization of the internal structures of the kidney, is inserted to view the area.
6. The area is irrigated to ensure clear visibility.
7. The provider removes any small kidney stones present.
8. For larger stones, the provider may use an ultrasonic device or a holmium laser lithotripter to fragment the stones before removal.
9. After stone removal, a nephrostomy tube, which connects the kidney to the skin, is inserted to allow for drainage of urine.
10. The incision is closed using large absorbable sutures.

4. Qualifying circumstances

CPT 50070 is specifically used when the nephrolithotomy procedure is complicated by a congenital kidney abnormality. This means that the patient must have a documented congenital kidney abnormality, such as a birth defect affecting the structure or function of the kidney. The procedure is performed to address the complications caused by the kidney malformation, specifically the presence of kidney stones. It is important to accurately document the congenital kidney abnormality and its relationship to the nephrolithotomy procedure when using CPT code 50070.

5. When to use CPT code 50070

CPT code 50070 should be used when performing a nephrolithotomy procedure in patients with a congenital kidney abnormality. It is important to ensure that the patient has a documented congenital kidney abnormality and that the procedure is being performed to address the complications caused by the kidney malformation, specifically the presence of kidney stones. If the patient does not have a congenital kidney abnormality or if the procedure is not being performed to address the complications caused by the kidney malformation, CPT code 50070 should not be used.

6. Documentation requirements

To support a claim for CPT code 50070, the healthcare provider must document the following information:

• Documentation of the patient’s congenital kidney abnormality
• Description of the complications caused by the kidney malformation
• Details of the nephrolithotomy procedure, including the incision, dissection, use of instruments, stone removal technique, and closure of the incision
• Documentation of any additional procedures or interventions performed during the nephrolithotomy
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 50070, it is important to ensure that the procedure is performed in patients with a documented congenital kidney abnormality and that the procedure is being performed to address the complications caused by the kidney malformation. CPT code 50070 should not be reported with other codes unless additional procedures or interventions are performed during the nephrolithotomy procedure. It is important to follow the specific billing guidelines provided by the payer to ensure accurate and appropriate reimbursement for the procedure.

8. Historical information

CPT code 50070 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates or changes since its addition.

9. Examples

1. A patient with a documented congenital kidney abnormality undergoes a nephrolithotomy procedure to remove kidney stones.
2. A healthcare provider performs a nephrolithotomy procedure on a patient with a congenital kidney abnormality, addressing the complications caused by the kidney malformation.
3. In a case involving a patient with a congenital kidney abnormality, a nephrolithotomy procedure is performed to remove kidney stones and alleviate the complications caused by the kidney malformation.
4. A nephrolithotomy procedure is performed on a patient with a documented congenital kidney abnormality, specifically to address the presence of kidney stones.
5. A healthcare provider performs a nephrolithotomy procedure on a patient with a congenital kidney abnormality, aiming to alleviate the complications caused by the kidney malformation and remove kidney stones.
6. In a case involving a patient with a congenital kidney abnormality, a nephrolithotomy procedure is performed to address the complications caused by the kidney malformation and remove kidney stones.
7. A patient with a documented congenital kidney abnormality undergoes a nephrolithotomy procedure to remove kidney stones and alleviate the complications caused by the kidney malformation.