How To Use CPT Code 50815

CPT 50815 describes the procedure for creating a ureterocolon conduit, including intestine anastomosis. This article will cover the official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50815?

CPT 50815 is used to describe the surgical procedure in which a provider creates a ureterocolon conduit. This involves making a small incision on the colon and attaching a ureter to it. The provider then stitches the colon end onto the abdominal wall, creating an artificial opening for the passage of urine. The remaining portion of the colon is attached back to the intestine to maintain continuity.

2. Official Description

The official description of CPT code 50815 is: ‘Ureterocolon conduit, including intestine anastomosis.’ If the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. After appropriate preparation and anesthesia, the provider makes a midline abdominal incision, cutting through the skin, muscles, and fascia.
2. The colon and ureter are carefully pulled out from the abdominal cavity.
3. A portion of the colon is excised, and a small incision is made on it.
4. The provider stitches the ureter to the incision, creating a new passage for urine into the colon segment.
5. Another small incision is made through the abdominal wall, creating an opening to the outside of the body.
6. The colon segment is stitched to the abdominal wall opening, forming an alternate outlet for urine.
7. The loose end of the colon is then stitched back to the main loop of the intestine to maintain continuity.
8. The abdominal cavity is irrigated with antibiotics, and the provider closes it with sutures.
9. The patient is transferred to the recovery room for further care.

4. Qualifying circumstances

CPT 50815 is typically performed on patients who have had their urinary bladder removed due to cancer or other reasons. The procedure is used to create an artificial passage for urine to exit the body. It is important to note that for a bilateral procedure, modifier 50 should be appended to the code.

5. When to use CPT code 50815

CPT code 50815 should be used when a provider performs the ureterocolon conduit procedure, including intestine anastomosis. It is important to ensure that the procedure meets the specific criteria outlined in the official description.

6. Documentation requirements

To support a claim for CPT 50815, the provider must document the following information:

• Patient’s diagnosis and the need for the ureterocolon conduit procedure
• Details of the procedure performed, including the specific steps taken
• Date of the procedure
• Any additional relevant information or complications encountered during the procedure
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 50815, ensure that the procedure meets the specific criteria outlined in the official description. It is important to append modifier 50 if the procedure is performed bilaterally. Review the billing guidelines provided by the payer to ensure accurate and appropriate coding and billing.

8. Historical information

CPT 50815 was added to the Current Procedural Terminology system on January 1, 1990. It underwent a code change on January 1, 2002, when the description was updated to include intestine anastomosis. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient undergoes the ureterocolon conduit procedure to create an alternate outlet for urine after bladder removal due to cancer.
2. A provider performs the ureterocolon conduit procedure on a patient who requires an artificial passage for urine due to bladder dysfunction.
3. A patient with a congenital urinary anomaly undergoes the ureterocolon conduit procedure to establish a new route for urine elimination.
4. A provider performs the ureterocolon conduit procedure on a patient with a history of chronic bladder infections and urinary incontinence.
5. A patient undergoes the ureterocolon conduit procedure as part of a complex urological reconstruction surgery.
6. A provider performs the ureterocolon conduit procedure on a patient with bladder dysfunction following a traumatic injury.
7. A patient with a history of recurrent bladder stones undergoes the ureterocolon conduit procedure to prevent further complications.
8. A provider performs the ureterocolon conduit procedure on a patient with a congenital bladder anomaly that cannot be corrected through other means.
9. A patient undergoes the ureterocolon conduit procedure as part of a comprehensive treatment plan for bladder cancer.
10. A provider performs the ureterocolon conduit procedure on a patient with a history of chronic urinary tract infections and bladder dysfunction.