How To Use CPT Code 50630

CPT 50630 describes the surgical procedure known as ureterolithotomy, specifically targeting the lower one-third of the ureter. This article will provide an overview of CPT 50630, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when CPT 50630 may be used.

1. What is CPT Code 50630?

CPT 50630 is a code used to describe a surgical procedure called ureterolithotomy. This procedure involves making an incision into the lower one-third of the ureter to remove a stone that is causing obstruction or other complications. It is important to note that this code specifically applies to the lower one-third of the ureter, and different codes exist for procedures targeting the upper or middle one-third of the ureter.

2. Official Description

The official description of CPT code 50630 is: ‘Ureterolithotomy; lower one-third of ureter.’ It is important to be aware of the specific anatomical location targeted by this procedure, as there are different codes for ureterolithotomy procedures performed on different parts of the ureter.

3. Procedure

1. During the ureterolithotomy procedure, the healthcare provider begins by making an incision in the skin of the abdomen overlying the lower one-third of the ureter.
2. They then carefully dissect the surrounding muscles, fat, and fascia to expose the ureter.
3. Once the ureter is visible, the provider makes an incision in the ureteral wall directly over the stone, allowing access to the stone within the ureter.
4. The stone is then removed through the incision in the ureter.
5. After the stone is removed, the provider inserts a catheter and flushes the surgical site with a sterile saline solution to ensure there are no remaining stones or fragments.
6. The incision in the ureter is repaired, and any bleeding is stopped.
7. Finally, the layers of tissue in the abdomen are sutured together to close the incision.

4. Qualifying circumstances

CPT 50630 is used when a stone is located in the lower one-third of the ureter and requires surgical intervention. It is important to note that different codes exist for ureterolithotomy procedures targeting the upper or middle one-third of the ureter. The procedure must be performed by a qualified healthcare provider and meet the specific anatomical criteria outlined in the code description.

5. When to use CPT code 50630

CPT code 50630 should be used when a stone is located in the lower one-third of the ureter and requires surgical removal. It is important to accurately document the anatomical location of the stone and ensure that the procedure aligns with the specific criteria outlined in the code description. If the stone is located in the upper or middle one-third of the ureter, different codes should be used.

6. Documentation requirements

When reporting CPT code 50630, the healthcare provider must document the following information:

• The diagnosis indicating the presence of a stone in the lower one-third of the ureter
• A detailed description of the procedure performed, including the specific steps taken
• The date of the procedure
• Any complications or additional findings during the procedure
• Any additional procedures or interventions performed during the same session
• The provider’s signature

7. Billing guidelines

When billing for CPT code 50630, it is important to ensure that the procedure meets the specific criteria outlined in the code description. Additionally, it is crucial to accurately document the anatomical location of the stone and any other relevant details. It is also important to be aware of any specific billing guidelines or modifiers that may apply to this procedure. It is recommended to consult the official coding guidelines and payer policies for specific billing requirements.

8. Historical information

CPT code 50630 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone no updates or changes since its addition. However, it is important to stay updated with any changes or revisions to the code in future editions of the CPT manual.

9. Examples

1. A healthcare provider performs a ureterolithotomy on a patient to remove a stone located in the lower one-third of the ureter.
2. During a surgical procedure, a surgeon makes an incision in the abdomen to access and remove a stone from the lower one-third of the patient’s ureter.
3. A urologist performs a ureterolithotomy on a patient with a stone obstructing the lower one-third of the ureter.
4. A patient undergoes a ureterolithotomy procedure to remove a stone that is causing pain and obstruction in the lower one-third of the ureter.
5. A healthcare provider performs a ureterolithotomy on a patient with a stone located in the lower one-third of the ureter, using a minimally invasive approach.
6. During a surgical procedure, a urologist removes a stone from the lower one-third of the patient’s ureter through an incision made in the abdomen.
7. A patient undergoes a ureterolithotomy to remove a stone that is causing recurrent urinary tract infections and discomfort in the lower one-third of the ureter.
8. A surgeon performs a ureterolithotomy on a patient with a large stone obstructing the lower one-third of the ureter.
9. A urologist performs a ureterolithotomy on a patient with a stone that is causing hydronephrosis in the lower one-third of the ureter.
10. A healthcare provider performs a ureterolithotomy on a patient with a stone located in the lower one-third of the ureter, using a robotic-assisted approach.