How To Use CPT Code 50830

CPT 50830 describes the procedure for urinary undiversion, which involves reestablishing the urinary tract after previous operations such as ileal conduits, ureterosigmoidostomy, or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy. 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 50830?

CPT 50830 is used to describe the procedure of urinary undiversion, which involves reestablishing the urinary tract after previous operations such as ileal conduits, ureterosigmoidostomy, or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy. This procedure is performed to create new entry points on the bladder and reimplant the ureters into the bladder.

2. Official Description

The official description of CPT code 50830 is: ‘Urinary undiversion (eg, taking down of ureteroileal conduit, ureterosigmoidostomy or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy)’

3. Procedure

1. The provider makes an incision below the navel in the midline and separates and retracts the rectus abdominis muscle.
2. The abdominal contents are retracted to gain a view of the bladder.
3. The provider identifies the ureters and takes down or removes the urinary diversion, such as an ileal or sigmoid conduit.
4. The ureters are reimplanted into the bladder or into each other and then into the bladder.
5. The provider creates two stomas on the frontal surface of the bladder and stitches the ureters placed through the stomas inside the bladder.
6. A stent may be placed within the ureter at the point of its attachment to the bladder for better support.
7. A urinary catheter may be connected for draining urine, and a drainage tube may be attached to prevent urine leakage from the site.
8. Drains are placed, and the wound is closed in layers.

4. Qualifying circumstances

Patients who have previously undergone ileal conduits, ureterosigmoidostomy, or ureteroenterostomy with ureteroureterostomy or ureteroneocystostomy may require urinary undiversion. The procedure is performed to reestablish the urinary tract and is typically done by a qualified healthcare professional.

5. When to use CPT code 50830

CPT code 50830 should be used when the provider performs the procedure of urinary undiversion, taking down a previous urinary diversion and reimplanting the ureters into the bladder. It should not be used for other procedures or conditions.

6. Documentation requirements

To support a claim for CPT 50830, the healthcare professional must document the following information:

• Patient’s medical history and previous urinary diversion procedure
• Details of the procedure performed, including the specific steps taken
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the healthcare professional performing the procedure

7. Billing guidelines

When billing for CPT 50830, ensure that the procedure meets the criteria for urinary undiversion and is performed by a qualified healthcare professional. Modifier 52 may be used if the provider only takes down or removes a urinary diversion without ureteral implantations. It is important to follow the specific guidelines and coding instructions provided by the payer.

8. Historical information

CPT 50830 was added to the Current Procedural Terminology system on January 1, 1990. In 2017, it was added under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A patient who previously had an ileal conduit undergoes urinary undiversion to reestablish the urinary tract.
2. A patient who had a ureterosigmoidostomy requires urinary undiversion to correct the urinary diversion and reimplant the ureters into the bladder.
3. A patient who had a ureteroenterostomy with ureteroureterostomy undergoes urinary undiversion to restore the normal urinary flow.
4. A patient with complications from a previous urinary diversion procedure undergoes urinary undiversion to address the issues and improve urinary function.
5. A patient with recurrent urinary tract infections due to a previous urinary diversion procedure undergoes urinary undiversion to prevent further infections and improve overall health.