How To Use CPT Code 50860

CPT 50860 describes the procedure of ureterostomy, which involves the transplantation of the ureter to the skin. This article will cover the description, official description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 50860?

CPT 50860 is a code used to describe the surgical procedure known as ureterostomy. This procedure involves creating an artificial opening to attach the ureter to the surface of the body, allowing urine to drain externally. It may be performed on one ureter or both, and the provider has various techniques to choose from when performing the surgery.

2. Official Description

The official description of CPT code 50860 is: ‘Ureterostomy, transplantation of ureter to skin.’ If the procedure is performed bilaterally, modifier 50 should be appended to the code.

3. Procedure

1. The provider begins by making an incision, either transverse or longitudinal, to access the abdomen and pelvis.
2. Once the ureter is located, it is freed from the surrounding connective tissue.
3. A loop of the ureter is brought out of the incision, and the fascia is closed under the loop to secure it in place.
4. The provider then makes a longitudinal incision in the ureter and inserts a catheter into the renal pelvis through the loop.
5. The edges of the incision in the ureter are brought together with the surrounding tissue and anchored to prevent narrowing of the opening.
6. Finally, the remaining incisions are closed in layers.

4. Qualifying circumstances

Patients who require ureterostomy are those who need an alternative method for urine drainage. This procedure may be necessary due to various conditions, such as urinary tract obstructions, bladder dysfunction, or other urinary system abnormalities. The decision to perform ureterostomy is made by the provider based on the patient’s specific circumstances and medical needs.

5. When to use CPT code 50860

CPT code 50860 should be used when the provider performs the transplantation of the ureter to the skin. It is important to note that this code is specific to the ureterostomy procedure and should not be used for other urinary system surgeries or interventions.

6. Documentation requirements

To support a claim for CPT code 50860, the provider must document the following information:

• Indication for the ureterostomy procedure
• Details of the surgical technique used
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 50860, ensure that the procedure meets the criteria outlined in the official description. If the procedure is performed bilaterally, modifier 50 should be appended to indicate a bilateral procedure. It is important to follow the specific guidelines provided by the payer to ensure accurate and appropriate reimbursement.

8. Historical information

CPT code 50860 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 patient with a urinary tract obstruction undergoes ureterostomy to provide an alternative route for urine drainage.
2. A provider performs ureterostomy on both ureters for a patient with bladder dysfunction.
3. An individual with a congenital urinary system abnormality requires ureterostomy to manage urine flow.
4. A patient with a history of recurrent urinary tract infections undergoes ureterostomy to alleviate symptoms and prevent further complications.
5. A provider performs ureterostomy as part of a complex urinary system reconstruction surgery for a patient with multiple abnormalities.
6. An individual with a neurogenic bladder requires ureterostomy to manage urine flow and prevent urinary retention.
7. A patient with bladder cancer undergoes ureterostomy as part of their treatment plan.
8. A provider performs ureterostomy on one ureter for a patient with a ureteral stricture.
9. An individual with a history of failed urinary system surgeries requires ureterostomy as a last resort for urine drainage.
10. A patient with a traumatic injury to the urinary system undergoes ureterostomy to restore urine flow.