How To Use CPT Code 51570

CPT 51570 describes the complete removal of the urinary bladder in a surgical procedure. This article will cover the description, official details, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information and billing examples.

1. What is CPT Code 51570?

CPT 51570 involves the surgical removal of the entire urinary bladder. This procedure is commonly performed to treat bladder cancer. The provider makes an incision in the abdomen, locates the bladder and tumor, detaches the bladder from surrounding organs, excises the bladder, and creates a method of urinary diversion. The abdominal wound is then closed, potentially leaving a drain in place.

2. Official Description

The official description of CPT code 51570 is: ‘Cystectomy, complete; (separate procedure).’ This code indicates the complete removal of the urinary bladder as a separate procedure. It is important to note that this code cannot be reported separately with a related procedure performed through the same skin incision in an anatomically related region. Modifier 59, Distinct Procedural Service, may be necessary if the procedure is performed with an unrelated procedure.

3. Procedure

1. The provider prepares the patient and makes an incision in the abdomen over the urinary bladder.
2. Subcutaneous tissue and muscles are dissected to access the bladder and tumor within the bladder wall.
3. The provider assesses the extent of the disease and detaches the bladder from surrounding organs.
4. All attached tissues are separated, and blood vessels are ligated as needed.
5. The bladder is excised from the surrounding structures and completely removed from the patient.
6. A separate procedure is performed to create a method of urinary diversion for the patient.
7. Bleeding is controlled, and the layers of tissue are sutured together to close the abdominal wound.
8. A drain may be left in place.

4. Qualifying circumstances

CPT 51570 is performed when there is a need to remove the entire urinary bladder. This procedure is commonly used to treat bladder cancer. The provider must assess the extent of the disease and determine that complete removal of the bladder is necessary. It is important to note that CPT 51570 cannot be reported with a related procedure performed through the same skin incision in an anatomically related region.

5. When to use CPT code 51570

CPT code 51570 should be used when the provider performs a complete cystectomy, removing the entire urinary bladder. This code should not be used when the procedure is performed in conjunction with a related procedure through the same skin incision in an anatomically related region. In such cases, modifier 59 may be necessary to indicate a distinct procedural service.

6. Documentation requirements

To support a claim for CPT 51570, the provider must document the following information:

• Patient’s diagnosis necessitating the complete cystectomy
• Details of the procedure, including the incision, dissection, removal of the bladder, and creation of urinary diversion
• Date of the procedure
• Any additional procedures performed in conjunction with CPT 51570
• Signature of the provider

7. Billing guidelines

When billing for CPT 51570, ensure that the procedure involves the complete removal of the urinary bladder. This code should not be reported with a related procedure performed through the same skin incision in an anatomically related region. Modifier 59 may be necessary if CPT 51570 is performed with an unrelated procedure. It is important to review payer-specific guidelines and documentation requirements for accurate billing.

8. Historical information

CPT 51570 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 undergoes a complete cystectomy to treat bladder cancer.
2. A provider performs a separate procedure to remove the entire urinary bladder due to extensive disease.
3. A complete cystectomy is performed as a standalone procedure to address a patient’s bladder condition.
4. A patient with bladder cancer undergoes a complete cystectomy, followed by the creation of a method of urinary diversion.
5. A provider performs a separate procedure to remove the entire urinary bladder and address the patient’s bladder-related health concerns.
6. A complete cystectomy is performed to treat a patient’s advanced bladder disease.
7. A provider performs a separate procedure to remove the entire urinary bladder and improve the patient’s quality of life.
8. A patient undergoes a complete cystectomy to eliminate bladder cancer and ensure disease eradication.
9. A provider performs a separate procedure to remove the entire urinary bladder and provide the patient with a fresh start.
10. A complete cystectomy is performed to address a patient’s bladder condition and prevent disease progression.