How To Use CPT Code 50546

CPT 50546 describes the laparoscopic surgical procedure for nephrectomy, which involves the removal of a kidney and partial ureterectomy. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50546?

CPT 50546 is used to describe a laparoscopic surgical procedure for nephrectomy, which involves the removal of a kidney and partial ureterectomy. This code is specifically used when the procedure is performed using a laparoscope, a minimally invasive technique that allows for smaller incisions and faster recovery times compared to traditional open surgery.

2. Official Description

The official description of CPT code 50546 is: ‘Laparoscopy, surgical; nephrectomy, including partial ureterectomy.’

3. Procedure

1. The patient is positioned in the prone position (supine for kidney transplant patients) and the surgical site is prepared and draped in a sterile manner.
2. Under general anesthesia, the surgeon makes four incisions below the rib cage to insert a laparoscope for visualization and trocars for instrument insertion.
3. The laparoscope allows the surgeon to view the kidney and surrounding structures.
4. The surgeon disconnects the ureter (the connection from the kidney to the bladder) and blood vessels, and then removes the kidney along with a section of the ureter.
5. The incisions are closed with staples or sutures, and the procedure is completed.

4. Qualifying circumstances

CPT 50546 is used when a laparoscopic nephrectomy is performed, specifically involving the removal of a kidney and partial ureterectomy. This procedure is typically indicated for conditions such as kidney tumors, severe kidney infections, or kidney donation for transplantation. The use of a laparoscope distinguishes this procedure from open surgical approaches.

5. When to use CPT code 50546

CPT code 50546 should be used when a laparoscopic nephrectomy is performed, including the removal of a kidney and partial ureterectomy. It is important to ensure that the procedure is performed using a laparoscope and not through an open surgical approach. If only the diseased or infected portion of the kidney is removed, CPT code 50543 (partial nephrectomy) should be used instead. If a radical nephrectomy is performed, which involves the removal of the kidney, a section of the ureter, the adrenal gland, and surrounding fatty tissue, CPT code 50545 should be used.

6. Documentation requirements

To support a claim for CPT code 50546, the following documentation should be included:

• Patient’s diagnosis and indication for the laparoscopic nephrectomy
• Details of the laparoscopic technique used, including the number and location of incisions
• Description of the procedure performed, including the removal of the kidney and partial ureterectomy
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed

7. Billing guidelines

When billing for CPT code 50546, it is important to ensure that the procedure was performed using a laparoscopic approach. If the procedure was performed through an open surgical approach, a different code should be used. It is also important to follow any specific billing guidelines provided by insurance payers or regulatory bodies. Modifier usage may be required in certain circumstances, so it is important to review the specific requirements for accurate billing.

8. Historical information

CPT code 50546 was added to the Current Procedural Terminology system on January 1, 2000. There have been no updates or changes to the code since its addition. However, it is worth noting that Medicare added this procedure to the Inpatient Only (IPO) list in 2017, indicating that it is typically performed in an inpatient setting.

9. Examples

1. A laparoscopic surgical procedure is performed to remove a kidney and a section of the ureter for a patient with a kidney tumor.
2. A laparoscopic nephrectomy is performed to treat a severe kidney infection in a patient.
3. A laparoscopic procedure is performed to remove a kidney for transplantation purposes.
4. A laparoscopic surgical technique is used to remove a kidney and a portion of the ureter for a patient with a congenital kidney abnormality.
5. A laparoscopic nephrectomy is performed to address a non-functioning kidney in a patient with end-stage renal disease.
6. A laparoscopic procedure is performed to remove a kidney and a section of the ureter for a patient with recurrent kidney stones.
7. A laparoscopic nephrectomy is performed to remove a kidney affected by a rare genetic disorder.
8. A laparoscopic surgical technique is used to remove a kidney and a portion of the ureter for a patient with a kidney cyst.
9. A laparoscopic procedure is performed to remove a kidney and a section of the ureter for a patient with polycystic kidney disease.
10. A laparoscopic nephrectomy is performed to remove a kidney affected by a benign tumor.