How To Use CPT Code 50785

CPT 50785 describes the surgical procedure known as ureteroneocystostomy, which involves transplanting the ureter to a different site in the urinary bladder. 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 50785?

CPT 50785 is used to describe a surgical procedure in which the provider transplants the ureter to a new opening in the urinary bladder. This procedure allows for an uninterrupted flow of urine. The ureter is connected to the bladder either by suturing the bladder and psoas muscle or by creating a long, elliptical flap from the bladder roof. This code is used for a unilateral procedure, and if it is performed bilaterally, modifier 50 should be appended to the code.

2. Official Description

The official description of CPT code 50785 is: ‘Ureteroneocystostomy; with vesico-psoas hitch or bladder flap.’ This code is used when the provider transplants the ureter to a different site in the urinary bladder, either by suturing the bladder and psoas muscle or by creating a flap from the bladder roof.

3. Procedure

1. The provider begins by making an incision in the abdomen over the location of the ureter.
2. They then dissect through the subcutaneous tissue to locate the ureter and identify the area of obstruction.
3. The nearby tissues and muscles are retracted, and the bladder is mobilized to reach the area of the ureteral obstruction.
4. The provider then dissects the ureteral obstruction and reattaches the rest of the ureter to the bladder.
5. To ensure there is no tension on the connection, the provider may suture the same side of the bladder roof where the implant is inserted to the fascia of the psoas major muscle.
6. If a psoas hitch is not possible, the provider may create a bladder flap from the roof of the bladder and connect it to the transected ureter to make a tension-free connection.
7. The provider closes the tube flap and the bladder wall, stops any bleeding, and closes the abdominal wound by suturing the layers of tissue together.

4. Qualifying circumstances

CPT 50785 is performed on patients who require the transplantation of the ureter to a different site in the urinary bladder. This procedure is typically done to allow for an uninterrupted flow of urine in cases of ureteral obstruction. The provider must suture the bladder and psoas muscle or create a bladder flap to connect the ureter to the bladder. This code is used for a unilateral procedure, and if it is performed bilaterally, modifier 50 should be appended to the code.

5. When to use CPT code 50785

CPT code 50785 should be used when the provider performs a ureteroneocystostomy procedure, transplanting the ureter to a different site in the urinary bladder. This code is used for a unilateral procedure, and if it is performed bilaterally, modifier 50 should be appended to the code.

6. Documentation requirements

To support a claim for CPT code 50785, the provider must document the following information:

• Patient’s diagnosis necessitating the ureteroneocystostomy procedure
• Details of the procedure performed, including whether a vesico-psoas hitch or bladder flap was used
• Date of the procedure
• Any additional relevant information, such as complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 50785, ensure that the procedure meets the criteria for ureteroneocystostomy and that the documentation supports the necessity of the procedure. This code is used for a unilateral procedure, and if it is performed bilaterally, modifier 50 should be appended to the code. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT code 50785 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 urologist performs a ureteroneocystostomy procedure on a patient with ureteral obstruction, connecting the ureter to a new opening in the bladder using a vesico-psoas hitch.
2. A surgeon performs a ureteroneocystostomy procedure on a patient with a history of bladder cancer, connecting the ureter to a new opening in the bladder using a bladder flap.
3. A urologist performs a unilateral ureteroneocystostomy procedure on a patient with recurrent urinary tract infections, connecting the ureter to a new opening in the bladder using a vesico-psoas hitch.
4. A surgeon performs a ureteroneocystostomy procedure on a patient with a congenital ureteral anomaly, connecting the ureter to a new opening in the bladder using a bladder flap.
5. A urologist performs a unilateral ureteroneocystostomy procedure on a patient with ureteral stricture, connecting the ureter to a new opening in the bladder using a vesico-psoas hitch.
6. A surgeon performs a ureteroneocystostomy procedure on a patient with a history of pelvic radiation, connecting the ureter to a new opening in the bladder using a bladder flap.