How To Use CPT Code 50280

CPT 50280 describes the excision or unroofing of cyst(s) of the kidney. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50280?

CPT 50280 can be used to describe the surgical procedure in which one or more cysts are excised or the covering of one or more cysts is removed from the surface of the kidney. This code is used when the provider makes an incision, accesses the cyst, and either removes it or eliminates it using fulguration. The procedure may also involve the insertion of a drain tube for temporary drainage.

2. Official Description

The official description of CPT code 50280 is: ‘Excision or unroofing of cyst(s) of kidney (For laparoscopic ablation of renal cysts, use 50541).’ This code was added to the Current Procedural Terminology system on January 1, 1990. It is important to note that this procedure is listed under the Inpatient Only (IPO) list for Medicare.

3. Procedure

1. To perform CPT 50280, the provider begins by making an incision in the skin over the affected kidney.
2. They then cut through the perirenal muscles and dissect the perirenal fat and Gerota’s fascia to access the cyst.
3. The provider identifies, opens, and aspirates the cyst, and may proceed to excise it or use fulguration to eliminate it.
4. If the provider chooses to perform an unroofing procedure, they use a needle to remove fluid from the cyst and then remove the cyst wall.
5. The base of the cyst defect is examined to ensure there is no evidence of renal tumors.
6. If necessary, a drain tube may be inserted and connected to a separate incision for temporary drainage.
7. Bleeding is controlled, and the incision used to access the kidney is closed.

4. Qualifying circumstances

CPT 50280 is performed on patients with cysts on the kidney surface. The procedure is typically indicated when the cysts cause symptoms or complications, such as pain, infection, or obstruction. It is important to note that this procedure is performed through an open incision and is not suitable for laparoscopic ablation of renal cysts.

5. When to use CPT code 50280

CPT code 50280 should be used when a provider performs the excision or unroofing of cyst(s) on the kidney surface through an open incision. It is important to ensure that the procedure is not performed laparoscopically, as a different code (50541) should be used in that case.

6. Documentation requirements

To support a claim for CPT 50280, the provider must document the following information:

• Patient’s diagnosis and the need for the excision or unroofing of kidney cyst(s)
• Details of the procedure, including the incision site, access to the cyst, and the method used for cyst removal or elimination
• Any additional procedures performed, such as the insertion of a drain tube
• Any complications or unexpected findings during the procedure
• Post-operative care instructions and any follow-up plans
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50280, ensure that the procedure is performed through an open incision and not laparoscopically. It is important to note that this procedure is listed under the Inpatient Only (IPO) list for Medicare, meaning it is typically performed on an inpatient basis. It is also important to follow any specific billing guidelines provided by the payer or coding guidelines.

8. Historical information

CPT 50280 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition. It is important to stay updated with any changes in coding guidelines or payer requirements.

9. Examples

1. A urologist performs an open incision and excises a kidney cyst in a patient with recurrent pain and infection.
2. A surgeon performs an unroofing procedure on a large kidney cyst in a patient with obstructive symptoms.
3. A nephrologist removes the covering of multiple kidney cysts in a patient with polycystic kidney disease.
4. A urologic oncologist performs an open partial nephrectomy for a renal cortical tumor, excluding any renal cysts.
5. A general surgeon excises a kidney cyst and performs a partial nephrectomy in a patient with a complex renal mass.
6. A urologist performs an open nephrectomy, removing the entire kidney along with a large cyst and surrounding lymph nodes.
7. A surgical team performs an open nephrectomy with total ureterectomy and bladder cuff removal in a patient with invasive bladder cancer and a kidney cyst.
8. A urologist performs an open nephrectomy, removing the entire kidney and adjacent lymph nodes, in a patient with advanced renal cell carcinoma.
9. A surgeon performs an open nephrectomy and removes multiple kidney cysts in a patient with end-stage renal disease.
10. A urologist performs an open nephrectomy and excises a large kidney cyst in a patient with a suspected renal tumor.