How To Use CPT Code 50620

CPT 50620 describes the surgical procedure known as ureterolithotomy, specifically targeting the middle one-third of the ureter. This article will provide an overview of CPT code 50620, 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 50620?

CPT 50620 is a code used to describe a surgical procedure called ureterolithotomy, which involves making an incision into the middle one-third of the ureter to remove a stone. This procedure is performed by a healthcare provider to alleviate the patient’s symptoms and prevent further complications associated with the presence of a stone in the ureter.

2. Official Description

The official description of CPT code 50620 is: ‘Ureterolithotomy; middle one-third of ureter.’

3. Procedure

1. During the procedure, the healthcare provider prepares the patient by ensuring appropriate anesthesia and positioning.
2. An incision is made in the abdominal skin overlying the middle one-third of the ureter.
3. The provider then carefully dissects the surrounding muscles, fat, and fascia to expose the ureter.
4. Once the ureter is visible, the provider makes an incision in the ureteral wall directly over the stone.
5. The stone is then removed through the incision in the ureter.
6. To ensure there are no residual stones or fragments, the provider flushes the surgical site with a sterile saline solution.
7. The incision in the ureter is repaired, and any bleeding is controlled.
8. Finally, the layers of tissue in the abdominal incision are sutured together to close the wound.

4. Qualifying circumstances

CPT 50620 is performed on patients who have a stone located in the middle one-third of the ureter. The procedure is indicated when the stone causes significant symptoms or poses a risk of complications. The healthcare provider must carefully assess the patient’s condition and determine that ureterolithotomy is the most appropriate treatment option.

5. When to use CPT code 50620

CPT code 50620 should be used when a healthcare provider performs ureterolithotomy specifically targeting the middle one-third of the ureter. It is important to note that this code should not be used for stones located in the upper or lower one-third of the ureter, as separate codes exist for those scenarios (CPT 50600 for the upper one-third and CPT 50630 for the lower one-third).

6. Documentation requirements

To support a claim for CPT 50620, the healthcare provider must document the following information:

• Patient’s diagnosis and the presence of a stone in the middle one-third of the ureter
• Details of the procedure, including the incision site and the removal of the stone
• Use of anesthesia and any complications encountered
• Any additional procedures performed during the same operative session
• Postoperative care instructions and any follow-up plans
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50620, ensure that the procedure is performed on the middle one-third of the ureter. It is important to follow the appropriate coding guidelines and not report CPT 50620 for stones located in the upper or lower one-third of the ureter. Additionally, be aware of any specific billing requirements from insurance providers or payers.

8. Historical information

CPT 50620 was added to the Current Procedural Terminology system on January 1, 1990. It was later designated as an Inpatient Only (IPO) procedure by Medicare in 2017.

9. Examples

1. A healthcare provider performs ureterolithotomy on a patient with a stone located in the middle one-third of the ureter.
2. During a surgical procedure, a stone is removed from the middle one-third of the ureter using ureterolithotomy.
3. A patient undergoes ureterolithotomy to alleviate symptoms caused by a stone in the middle one-third of the ureter.
4. A healthcare provider performs an incision into the middle one-third of the ureter to remove a stone using ureterolithotomy.
5. Ureterolithotomy is performed on a patient with a stone located in the middle one-third of the ureter to improve their condition.
6. A stone is successfully removed from the middle one-third of the ureter using ureterolithotomy during a surgical procedure.
7. A healthcare provider performs ureterolithotomy to address a stone in the middle one-third of the ureter and alleviate the patient’s symptoms.
8. During a surgical intervention, a stone is extracted from the middle one-third of the ureter using ureterolithotomy.
9. A patient undergoes ureterolithotomy to remove a stone located in the middle one-third of the ureter and improve their overall health.
10. A healthcare provider performs an incision into the middle one-third of the ureter to remove a stone and restore normal urinary flow using ureterolithotomy.