How To Use CPT Code 51550

CPT 51550 describes the surgical procedure known as partial cystectomy, which involves the removal of a portion of the urinary bladder. This article will provide an overview of CPT 51550, including its official description, the procedure itself, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, and examples of when CPT 51550 may be used.

1. What is CPT Code 51550?

CPT 51550 is used to describe a surgical procedure called partial cystectomy. This procedure involves the removal of a specific portion of the urinary bladder. It is typically performed to treat conditions such as bladder cancer or damage to the bladder. The provider surgically excises the diseased tissue along with a margin of healthy tissue surrounding the bladder.

2. Official Description

The official description of CPT code 51550 is: ‘Cystectomy, partial; simple.’

3. Procedure

1. During the procedure, the provider makes an incision in the abdominal skin overlying the urinary bladder.
2. They then dissect through the subcutaneous tissue and muscles to reach the bladder.
3. An incision is made in the bladder wall to visualize the tumor or damaged tissue that needs to be removed.
4. The provider excises the tumor or damaged tissue along with a margin of normal tissue surrounding the bladder.
5. The bladder is closed in two layers using sutures.
6. A catheter is placed to drain urine and prevent leakage from the surgical site.
7. Bleeding is controlled, a drain is placed, and the layers of tissue are sutured to close the abdominal wound.
8. The drainage tube and catheter are typically removed after five days.

4. Qualifying circumstances

CPT 51550 is performed when there is a need to surgically remove a part of the urinary bladder. This procedure is commonly used to treat bladder cancer or damage to the bladder. It is important to note that CPT 51550 is specifically for simple cystectomies, which do not involve any complications such as previous radiation therapy, previous surgery, or difficulty accessing the diseased bladder tissue.

5. When to use CPT code 51550

CPT code 51550 should be used when a provider performs a simple cystectomy, which involves the removal of a part of the urinary bladder without any complications. If the procedure is complicated due to factors such as previous radiation therapy, previous surgery, or difficulty accessing the diseased bladder tissue, CPT code 51555 should be used instead.

6. Documentation requirements

To support a claim for CPT 51550, the provider must document the following information:

• Patient’s diagnosis necessitating the partial cystectomy
• Details of the procedure, including the incision, excision of the tumor or damaged tissue, closure of the bladder, and closure of the abdominal wound
• Date of the procedure
• Any complications or additional procedures performed
• Signature of the provider performing the procedure

7. Billing guidelines

When billing for CPT 51550, ensure that the procedure performed is a simple cystectomy without any complications. If the procedure is complicated, CPT code 51555 should be used instead. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 51550 was added to the Current Procedural Terminology system on January 1, 1990. The code has not undergone any updates since its addition. It is worth noting that as of 2017, CPT 51550 is listed under the Inpatient Only (IPO) list for Medicare.

9. Examples

1. A provider performs a partial cystectomy to remove a tumor from the urinary bladder of a patient with bladder cancer.
2. A patient sustains bladder damage due to trauma, and a provider performs a partial cystectomy to repair the damaged bladder tissue.
3. A provider surgically removes a portion of the urinary bladder to treat a patient with a non-cancerous bladder condition.
4. A patient undergoes a partial cystectomy to remove a diseased portion of the bladder that is causing recurrent infections.
5. A provider performs a partial cystectomy to remove a tumor from the urinary bladder of a patient with a history of bladder cancer.
6. Provide four more examples of cases where CPT code 51550 may be used. Ensure that each example is original and does not include ‘CPT 51550’ or ‘CPT code 51550’ in the text.