How To Use CPT Code 50727

CPT 50727 describes the revision of a urinary-cutaneous anastomosis, which involves the modification of an artificial opening between the skin and the urinary tract. 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 50727?

CPT 50727 is used to describe the revision of a urinary-cutaneous anastomosis, specifically the modification of an artificial opening between the skin and the urinary tract. This procedure is performed by a healthcare provider to address defects or issues in the urinary or renal collecting system, such as blockages, ruptures, or other abnormalities.

2. Official Description

The official description of CPT code 50727 is: ‘Revision of urinary-cutaneous anastomosis (any type urostomy).’ This code encompasses the revision of the connection between the skin and the urinary tract, which may involve the ureter, bladder, colon segment, or kidney.

3. Procedure

1. The healthcare provider begins by making a skin incision around the opening of the ureter.
2. Scar tissues surrounding the ureteral opening are dissected, and if necessary, the provider advances the incision through the fascia.
3. The distal portion of the urinary tissue, along with surrounding tissues, is removed to free the artificial opening.
4. The provider then revises the connection between the two structures, ensuring proper alignment and function.
5. Once the revision is complete, the skin incision is closed.

4. Qualifying circumstances

CPT 50727 is performed on patients who have previously undergone a urinary-cutaneous anastomosis and require a revision due to defects or issues in the urinary or renal collecting system. The procedure may be necessary to address blockages, ruptures, or other abnormalities in the connection between the skin and the urinary tract. It is important to note that this code applies to any type of urostomy, including those involving the ureter, bladder, colon segment, or kidney.

5. When to use CPT code 50727

CPT code 50727 should be used when a healthcare provider performs a revision of a urinary-cutaneous anastomosis, specifically modifying the artificial opening between the skin and the urinary tract. This code is appropriate when addressing defects or issues in the urinary or renal collecting system, such as blockages, ruptures, or other abnormalities. It is important to accurately document the specific circumstances that warrant the revision.

6. Documentation requirements

To support a claim for CPT code 50727, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for revision of the urinary-cutaneous anastomosis
• Details of the procedure, including the specific structures involved (ureter, bladder, colon segment, or kidney)
• Date of the procedure
• Incision site and any additional incisions made
• Steps taken during the revision, including dissection of scar tissues and removal of urinary tissue
• Closure of the skin incision
• Any complications or unexpected findings during the procedure
• Signature of the healthcare provider performing the revision

7. Billing guidelines

When billing for CPT code 50727, ensure that the procedure performed aligns with the description of the code. It is important to accurately document the revision of the urinary-cutaneous anastomosis and any additional procedures performed, such as repair of fascial defects or hernias. If a repair of fascial defect and hernia is performed along with the revision, use CPT code 50728. It is crucial to follow the specific guidelines provided by the payer and to accurately report any additional procedures or services provided during the same encounter.

8. Historical information

CPT code 50727 was added to the Current Procedural Terminology system on January 1, 1993. There have been no updates or changes to the code since its addition.

9. Examples

1. A healthcare provider performs a revision of a urinary-cutaneous anastomosis, specifically modifying the connection between the skin and the bladder, to address a blockage in the urinary tract.
2. A patient who previously underwent a urinary-cutaneous anastomosis requires a revision due to a rupture in the connection between the skin and the ureter. The healthcare provider performs the necessary procedure to repair the defect.
3. A healthcare provider revises a urinary-cutaneous anastomosis involving the colon segment, as the patient is experiencing complications related to the initial procedure.
4. A patient presents with a defect in the urinary-cutaneous anastomosis involving the kidney. The healthcare provider performs a revision to address the issue and ensure proper functioning of the connection.
5. A healthcare provider performs a revision of a urinary-cutaneous anastomosis, modifying the connection between the skin and the bladder, to address a defect in the urinary tract.
6. A patient requires a revision of a urinary-cutaneous anastomosis involving the ureter, as the initial procedure did not result in proper alignment and function. The healthcare provider performs the necessary revision to correct the issue.
7. A healthcare provider revises a urinary-cutaneous anastomosis involving the colon segment, as the patient is experiencing complications related to the initial procedure.
8. A patient presents with a defect in the urinary-cutaneous anastomosis involving the kidney. The healthcare provider performs a revision to address the issue and ensure proper functioning of the connection.