How To Use CPT Code 50825

CPT 50825 describes a surgical procedure known as continent diversion, which involves creating a reservoir using a segment of the small or large intestine. This article will provide an overview of CPT 50825, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and similar codes.

1. What is CPT Code 50825?

CPT 50825 is a code used to describe a surgical procedure called continent diversion. During this procedure, a qualified healthcare provider creates a reservoir using a section of the small or large intestine. The ureters are then sutured to the reservoir, allowing urine to drain into it. This procedure is typically performed after the removal of the bladder.

2. Official Description

The official description of CPT code 50825 is: ‘Continent diversion, including intestine anastomosis using any segment of small and/or large intestine (Kock pouch or Camey enterocystoplasty).’ This code encompasses the creation of a reservoir using a segment of the intestine, as well as the anastomosis of the ureters to the reservoir.

3. Procedure

1. The healthcare provider begins by making an incision below the navel in the midline.
2. They then separate and retract the rectus abdominis muscle to gain access to the small or large intestine.
3. A portion of the intestine is isolated and removed, ensuring its vascularity.
4. The cut ends of the intestine are then sutured together to restore bowel continuity.
5. The isolated portion of the intestine is used to create the reservoir, such as a pouch or a trough.
6. The ureters are sutured to the reservoir, allowing urine to drain into it.
7. A stoma, or external opening, is created on the lower abdomen to allow for the discharge of urine.
8. The wound is closed in layers to promote healing.

4. Qualifying circumstances

CPT 50825 is performed on patients who require continent diversion due to the removal of the bladder. The procedure involves the creation of a reservoir using a segment of the small or large intestine, and the anastomosis of the ureters to the reservoir. It is important to note that this procedure is typically performed by a qualified healthcare provider with expertise in urological surgery.

5. When to use CPT code 50825

CPT code 50825 should be used when a healthcare provider performs the continent diversion procedure, including the creation of a reservoir using a segment of the small or large intestine, and the anastomosis of the ureters to the reservoir. It is important to accurately document the details of the procedure to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 50825, the healthcare provider must document the following information:

• Patient’s diagnosis and the need for continent diversion
• Details of the procedure, including the specific segment of the intestine used and the method of anastomosis
• Date of the procedure
• Any additional procedures performed during the same operative session
• Any complications or unexpected findings
• Signature of the healthcare provider performing the procedure

7. Billing guidelines

When billing for CPT code 50825, it is important to ensure that the procedure meets the criteria outlined in the official description. The healthcare provider should be qualified and experienced in performing continent diversion procedures. It is also important to accurately document the details of the procedure to support the use of this code. Additionally, it is important to follow any specific billing guidelines provided by the payer or insurance company.

8. Historical information

CPT code 50825 was added to the Current Procedural Terminology system on January 1, 1990. It underwent a code change on January 1, 2002, with an updated description that included the use of any segment of the small and/or large bowel. In 2017, it was added to the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A qualified healthcare provider performs continent diversion using a segment of the small intestine to create a reservoir for a patient who has undergone bladder removal.
2. A urological surgeon performs continent diversion using a segment of the large intestine to create a reservoir for a patient with bladder dysfunction.
3. A skilled healthcare provider performs continent diversion using a segment of the small and large intestine to create a reservoir for a patient with a history of bladder cancer.
4. An experienced surgeon performs continent diversion using a segment of the small intestine to create a reservoir for a patient with neurogenic bladder.
5. A urologist performs continent diversion using a segment of the large intestine to create a reservoir for a patient with urinary incontinence.
6. A qualified healthcare provider performs continent diversion using a segment of the small and large intestine to create a reservoir for a patient with bladder exstrophy.
7. An experienced surgeon performs continent diversion using a segment of the small intestine to create a reservoir for a patient with a congenital bladder anomaly.
8. A urological surgeon performs continent diversion using a segment of the large intestine to create a reservoir for a patient with recurrent urinary tract infections.
9. A skilled healthcare provider performs continent diversion using a segment of the small and large intestine to create a reservoir for a patient with bladder dysfunction following pelvic radiation therapy.
10. An experienced surgeon performs continent diversion using a segment of the small intestine to create a reservoir for a patient with interstitial cystitis.