How To Use CPT Code 50728

CPT 50728 describes the revision of a urinary-cutaneous anastomosis, which involves repairing a fascial defect and hernia. 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 50728?

CPT 50728 is used to describe the revision of a urinary-cutaneous anastomosis, which involves repairing a fascial defect and hernia. This procedure is performed by a healthcare provider to revise an artificial opening, or stoma, between the skin and the urinary tract that was previously created. The provider also repairs any defects in the fascia, the fibrous tissue surrounding the anastomosis, and addresses any hernias that may be present.

2. Official Description

The official description of CPT code 50728 is: ‘Revision of urinary-cutaneous anastomosis (any type urostomy); with repair of fascial defect and hernia.’

3. Procedure

1. The healthcare provider begins by making a skin incision around the opening of the ureter.
2. Scar tissue surrounding the ureteral opening is dissected, and if necessary, the incision is extended through the fascia.
3. The provider removes the distal portion of the urinary tissue along with the surrounding tissues to free the artificial opening, allowing for revision.
4. If there is a fascial defect or hernia present, the provider makes an incision over the protrusion and removes the tissues.
5. The defect in the fascia covering the structures is repaired.
6. Finally, the provider closes the skin incision.

4. Qualifying circumstances

CPT 50728 is performed on patients who have previously undergone a urinary-cutaneous anastomosis and require revision. The procedure is used to repair a fascial defect and hernia associated with the anastomosis. The specific type of urostomy, whether it is between the skin and the ureter, bladder, colon segment, or kidney, will determine the approach taken during the revision.

5. When to use CPT code 50728

CPT code 50728 should be used when a healthcare provider performs a revision of a urinary-cutaneous anastomosis and repairs a fascial defect and hernia. It is important to accurately document the specific details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT 50728, the healthcare provider must document the following information:

• Patient’s medical history and the need for revision of the urinary-cutaneous anastomosis
• Details of the procedure, including the specific type of urostomy and the approach taken for revision
• Date of the procedure and the duration of the surgery
• Description of the repair of the fascial defect and hernia
• Any additional procedures performed during the same surgical session
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT 50728, ensure that the procedure meets the criteria for revision of a urinary-cutaneous anastomosis with repair of a fascial defect and hernia. It is important to accurately document the details of the procedure to support the use of this code. Additionally, be aware of any specific billing guidelines or modifiers that may be required by the payer.

8. Historical information

CPT 50728 was added to the Current Procedural Terminology system on January 1, 1993. The code has not undergone any updates 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 revision of a urinary-cutaneous anastomosis, repairing a fascial defect and hernia in a patient who previously underwent a urostomy between the skin and the bladder.
2. During a surgical procedure, a provider revises a urinary-cutaneous anastomosis, repairs a fascial defect and hernia, and creates a new stoma for a patient with a urostomy between the skin and the colon segment.
3. A healthcare provider performs a revision of a urinary-cutaneous anastomosis, repairing a fascial defect and hernia, and reimplants the ureter for a patient with a urostomy between the skin and the kidney.
4. During a surgical procedure, a provider revises a urinary-cutaneous anastomosis, repairs a fascial defect and hernia, reimplants the ureter, and creates a new stoma for a patient with a urostomy between the skin and the bladder.
5. A healthcare provider performs a revision of a urinary-cutaneous anastomosis, repairing a fascial defect and hernia, reimplants the ureter, and revises the stoma for a patient with a urostomy between the skin and the colon segment.