How To Use CPT Code 50770

CPT 50770 describes the procedure known as transureteroureterostomy, which involves the anastomosis of the ureter to the contralateral ureter. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50770?

CPT 50770 is used to describe a surgical procedure in which the provider removes a blocked or injured portion of the ureter and joins the remaining portion of the ureter to the healthy ureter on the opposite side of the body. This procedure is performed when the length of the remaining ureter is insufficient for anastomosis to the bladder.

2. Official Description

The official description of CPT code 50770 is: ‘Transureteroureterostomy, anastomosis of ureter to contralateral ureter.’

3. Procedure

1. The provider makes an incision in the midline below the navel and retracts the rectus abdominis muscle.
2. They identify the large intestine, inferior vena cava, common iliac vessel, and uterine artery (in females) to avoid injury.
3. The provider mobilizes the portion of the ureter to be removed, taking care not to damage the surrounding blood vessels.
4. They excise the blocked or injured portion of the ureter.
5. A tunnel is created through the sigmoid colon mesentery, and the donor ureter is pulled across the midline through this tunnel.
6. A small opening is made in the healthy recipient ureter, and the donor ureteral end is anastomosed to the recipient ureter.
7. The provider stitches together the fibrous and muscular layers of the ureter, avoiding occlusion of the lumen.
8. A double J stent is inserted to support the anastomosis site, and a drain is placed near the site to prevent fluid collection.
9. The wound is closed in layers.

4. Qualifying circumstances

CPT 50770 is performed when the length of the remaining ureter after removing the blocked or injured portion is insufficient for anastomosis to the bladder. This procedure is typically done to treat a significantly traumatized ureteral stricture by connecting one ureter to the other. It is important for the provider to avoid injury to nearby structures, such as the large intestine, inferior vena cava, common iliac vessel, and uterine artery (in females).

5. When to use CPT code 50770

CPT code 50770 should be used when the provider performs a transureteroureterostomy procedure, anastomosing the ureter to the contralateral ureter. It should not be used when the provider leaves the ureter on the same side after repairing the stricture.

6. Documentation requirements

To support a claim for CPT 50770, the provider must document the following information:

• Patient’s diagnosis and the need for transureteroureterostomy
• Details of the procedure, including the incision site, structures identified, and steps performed
• Length of the remaining ureter after removing the blocked or injured portion
• Description of the anastomosis technique used
• Placement of a double J stent and drain
• Any complications or additional procedures performed
• Signature of the provider

7. Billing guidelines

When billing for CPT 50770, ensure that the procedure performed meets the criteria for transureteroureterostomy. It is important to provide detailed documentation to support the medical necessity of the procedure. There are no specific guidelines regarding reporting CPT code 50770 with other codes.

8. Historical information

CPT 50770 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes transureteroureterostomy to anastomose the ureter to the contralateral ureter after the removal of a blocked portion.
2. A provider performs transureteroureterostomy to connect the remaining portion of the ureter to the healthy ureter on the opposite side of the body.
3. Transureteroureterostomy is performed to treat a significantly traumatized ureteral stricture by joining one ureter to the other.
4. A patient with an insufficient length of the remaining ureter undergoes transureteroureterostomy to ensure proper urinary flow.
5. A provider performs transureteroureterostomy to correct a congenital abnormality in the urinary tract.
6. Transureteroureterostomy is performed to restore normal urine flow in a patient with a blocked or injured ureter.
7. A patient with a ureteral stricture undergoes transureteroureterostomy to improve urinary function.
8. A provider performs transureteroureterostomy to treat a patient with recurrent urinary tract infections caused by a blocked ureter.
9. Transureteroureterostomy is performed to alleviate symptoms and improve the quality of life in a patient with a ureteral obstruction.
10. A patient with a history of ureteral injury undergoes transureteroureterostomy to restore proper urinary function.