How To Use CPT Code 50845

CPT 50845 describes a surgical procedure known as cutaneous appendico-vesicostomy. 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 50845?

CPT 50845 is a code used to describe a surgical procedure called cutaneous appendico-vesicostomy. This procedure involves the creation of an external opening for the outflow of urine by connecting a portion of the appendix to the urinary bladder and the abdominal wall. The purpose of this procedure is to facilitate urine excretion in patients with neurogenic or congenital dysfunction of the urinary bladder.

2. Official Description

The official description of CPT code 50845 is: ‘Cutaneous appendico-vesicostomy, including reestablishment of bowel continuity (List separately in addition to code for primary procedure).’ This code should be reported separately in addition to the primary procedure code.

3. Procedure

1. The 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 right colon and appendix.
3. A portion of the appendix is isolated and its vascularity is ensured.
4. One end of the appendix is sutured to a hole created in the urinary bladder.
5. The cut ends of the intestine are then sutured together to reestablish bowel continuity.
6. To create the external opening, an incision is made on the lower abdomen or at the umbilicus.
7. The distal end of the appendix is drawn through the channel created and sutured to the abdominal skin, forming a raised mouth-like opening for urine discharge.
8. The provider ensures that there is no tension or stretch in the passage created and may place drains if necessary.
9. The wound is then closed in layers.

4. Qualifying circumstances

CPT 50845 is performed in patients with neurogenic or congenital dysfunction of the urinary bladder. It is primarily used to facilitate urine excretion in these patients. The procedure involves the connection of a portion of the appendix to the urinary bladder and the creation of an external opening for urine discharge. It is important to note that this procedure should be performed by a qualified healthcare professional with expertise in this specific surgical technique.

5. When to use CPT code 50845

CPT code 50845 should be used when the provider performs a cutaneous appendico-vesicostomy procedure, including the reestablishment of bowel continuity. This code should be reported separately in addition to the primary procedure code. It is important to review the documentation and ensure that the procedure meets the specific criteria outlined in the official description of CPT code 50845.

6. Documentation requirements

To support a claim for CPT code 50845, the provider must document the following information:

• Indication for the procedure, such as neurogenic or congenital dysfunction of the urinary bladder
• Description of the procedure performed, including the connection of the appendix to the urinary bladder and the creation of the external opening
• Date of the procedure
• Any additional procedures performed in conjunction with CPT code 50845
• Any complications or unexpected findings
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT code 50845, ensure that the procedure meets the specific criteria outlined in the official description. This code should be reported separately in addition to the primary procedure code. It is important to review the documentation and accurately report the services provided. Additionally, follow any specific billing guidelines provided by the payer to ensure proper reimbursement.

8. Historical information

CPT code 50845 was added to the Current Procedural Terminology system on January 1, 1994. In 2017, it was added to the Inpatient Only (IPO) list for Medicare reimbursement.

9. Examples

1. A patient with neurogenic dysfunction of the urinary bladder undergoes a cutaneous appendico-vesicostomy procedure to facilitate urine excretion.
2. A provider performs a cutaneous appendico-vesicostomy in a patient with congenital dysfunction of the urinary bladder to create an external opening for urine discharge.
3. During a surgical procedure, a portion of the appendix is connected to the urinary bladder and an external opening is created for urine outflow in a patient with neurogenic dysfunction of the urinary bladder.
4. A provider performs a cutaneous appendico-vesicostomy to facilitate urine excretion in a patient with congenital dysfunction of the urinary bladder.
5. In a surgical setting, a cutaneous appendico-vesicostomy procedure is performed to create an external opening for urine discharge in a patient with neurogenic dysfunction of the urinary bladder.
6. A patient with congenital dysfunction of the urinary bladder undergoes a cutaneous appendico-vesicostomy to facilitate urine excretion.
7. A provider performs a cutaneous appendico-vesicostomy in a patient with neurogenic dysfunction of the urinary bladder to create an external opening for urine discharge.
8. During a surgical procedure, a portion of the appendix is connected to the urinary bladder and an external opening is created for urine outflow in a patient with congenital dysfunction of the urinary bladder.
9. A provider performs a cutaneous appendico-vesicostomy to facilitate urine excretion in a patient with neurogenic dysfunction of the urinary bladder.
10. In a surgical setting, a cutaneous appendico-vesicostomy procedure is performed to create an external opening for urine discharge in a patient with congenital dysfunction of the urinary bladder.