How To Use CPT Code 50526

CPT 50526 describes the closure of a nephrovisceral fistula using a thoracic approach. 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 50526?

CPT 50526 is used to describe the surgical closure of a nephrovisceral fistula, which is an abnormal passageway between the kidney and other internal organs, such as the colon. The procedure is performed using a thoracic approach, where the provider makes an incision into the chest to access the affected area.

2. Official Description

The official description of CPT code 50526 is: ‘Closure of nephrovisceral fistula (eg, renocolic), including visceral repair; thoracic approach.’

3. Procedure

1. The provider begins by making an incision into the chest to access the affected area.
2. They then excise the perirenal muscles and dissect the surrounding fatty layers to visualize the abnormal passageway.
3. A catheter and radiopaque substance are inserted into the ureter to identify the extent and path of the fistula through the tissues.
4. The provider excises the upper surface of the passageway and sutures healthy tissues together to close the open pathway.
5. A drainage catheter is placed through a separate incision to remove any fluid or infected material.
6. Finally, the incision site is closed with sutures.

4. Qualifying circumstances

CPT 50526 is performed on patients with a nephrovisceral fistula, which is an abnormal communication between the kidney and other internal organs. The procedure is done using a thoracic approach, and the patient must meet the necessary criteria for surgical intervention.

5. When to use CPT code 50526

CPT code 50526 should be used when a provider performs the closure of a nephrovisceral fistula using a thoracic approach. It is important to ensure that the procedure meets the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 50526, the provider must document the following information:

• Patient’s diagnosis of a nephrovisceral fistula
• Details of the thoracic approach used for the closure
• Date of the procedure
• Specific steps taken during the procedure
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 50526, ensure that the procedure meets the requirements outlined in the code description. It is important to follow the appropriate coding guidelines and modifiers, if applicable. Additionally, be aware of any specific billing rules or regulations set by payers or insurance companies.

8. Historical information

CPT 50526 was added to the Current Procedural Terminology system on January 1, 1990. It was later added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A urologist performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with a history of kidney and colon complications.
2. A surgeon utilizes CPT 50526 to close a nephrovisceral fistula in a patient’s kidney and colon, opting for a thoracic approach.
3. During a surgical procedure, a provider performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with a complex medical history.
4. A nephrologist performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with recurring kidney and colon issues.
5. A surgical team utilizes CPT 50526 to close a nephrovisceral fistula in a patient’s kidney and colon, opting for a thoracic approach.
6. During a complex surgical procedure, a provider performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with multiple underlying health conditions.
7. An interventional radiologist performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with a history of kidney and colon complications.
8. A surgeon utilizes CPT 50526 to close a nephrovisceral fistula in a patient’s kidney and colon, opting for a thoracic approach.
9. During a minimally invasive procedure, a provider performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with a complex medical history.
10. A urologist performs the closure of a nephrovisceral fistula using a thoracic approach for a patient with recurring kidney and colon issues.