How To Use CPT Code 50660

CPT 50660 describes the surgical procedure of ureterectomy, specifically for the total removal of an ectopic ureter using a combination of abdominal, vaginal, and/or perineal approaches. This article will provide an overview of CPT code 50660, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples.

1. What is CPT Code 50660?

CPT 50660 is a code used to describe the surgical removal of an abnormal ureter that is not in its proper position and terminates at a different site. This procedure involves a combination of approaches, including abdominal, vaginal, and/or perineal, to access and remove the ectopic ureter. It is important to note that this code specifically refers to the total removal of the ureter.

2. Official Description

The official description of CPT code 50660 is: ‘Ureterectomy, total, ectopic ureter, combination abdominal, vaginal and/or perineal approach.’

3. Procedure

1. The provider begins by making an incision in the skin of the abdomen over the ectopic ureter.
2. Next, the provider carefully dissects through the muscles, fat, and surrounding fascia to expose the abnormal ureter.
3. Once the ectopic ureter is exposed, the provider examines the urinary system for any other abnormalities or diseases, as well as the terminal point of the ectopic ureter.
4. Another incision is made in the vagina or perineum at the termination site of the ureter.
5. The provider then dissects the ectopic ureter from its incorrect site of insertion and removes it.
6. After completing the ureterectomy, the provider closes the opening in the bladder and may place a drainage tube for temporary urine flow.

4. Qualifying circumstances

CPT code 50660 is applicable when a patient has an ectopic ureter, which is a condition where the ureter is not in its proper position and terminates at a different site. The procedure is performed by a provider who utilizes a combination of abdominal, vaginal, and/or perineal approaches to remove the entire ectopic ureter. It is important to note that this code specifically refers to the total removal of the ureter.

5. When to use CPT code 50660

CPT code 50660 should be used when a provider performs a total ureterectomy using a combination of abdominal, vaginal, and/or perineal approaches. It is important to ensure that the procedure involves the complete removal of the ectopic ureter. If only a section of the ureter is removed along with a bladder cuff, a separate procedure code should be used.

6. Documentation requirements

When reporting CPT code 50660, the provider must document the following information:

• Patient’s diagnosis indicating the presence of an ectopic ureter
• Details of the surgical procedure, including the specific approaches used (abdominal, vaginal, and/or perineal)
• Incision sites and their locations
• Findings during the procedure, such as any additional abnormalities or diseases
• Completion of the total ureterectomy
• Closure of the bladder opening and placement of a drainage tube, if applicable

7. Billing guidelines

When billing for CPT code 50660, it is important to ensure that the procedure performed aligns with the code’s description. The provider should use the appropriate combination of abdominal, vaginal, and/or perineal approaches to remove the ectopic ureter. It is also crucial to follow any additional guidelines provided by payers or coding authorities.

8. Historical information

CPT code 50660 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was also added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs a total ureterectomy using a combination of abdominal and vaginal approaches to remove an ectopic ureter in a female patient.
2. Using a combination of abdominal and perineal approaches, a provider performs a total ureterectomy to remove an ectopic ureter in a male patient.
3. A patient with an ectopic ureter undergoes a total ureterectomy using a combination of abdominal, vaginal, and perineal approaches.
4. A provider performs a total ureterectomy using only an abdominal approach to remove an ectopic ureter in a patient.
5. Using a combination of vaginal and perineal approaches, a provider performs a total ureterectomy to remove an ectopic ureter in a female patient.
6. A male patient undergoes a total ureterectomy using a combination of abdominal and vaginal approaches to remove an ectopic ureter.
7. A provider performs a total ureterectomy using a combination of abdominal and perineal approaches to remove an ectopic ureter in a male patient.
8. Using a combination of abdominal, vaginal, and perineal approaches, a provider performs a total ureterectomy to remove an ectopic ureter in a female patient.
9. A patient with an ectopic ureter undergoes a total ureterectomy using only an abdominal approach.
10. Using a combination of vaginal and perineal approaches, a provider performs a total ureterectomy to remove an ectopic ureter in a male patient.