How To Use CPT Code 51575

CPT 51575 describes the complete removal of the urinary bladder along with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes. 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 51575?

CPT 51575 can be used to describe the surgical procedure in which the provider removes the entire urinary bladder. Additionally, the procedure includes the removal of bilateral pelvic lymph nodes, specifically the external iliac, hypogastric, and obturator nodes. This code is typically used when there is cancer present in multiple areas of the bladder.

2. Official Description

The official description of CPT code 51575 is: ‘Cystectomy, complete; with bilateral pelvic lymphadenectomy, including external iliac, hypogastric, and obturator nodes.’

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 locate the bladder and the tumor within the bladder wall.
3. The provider assesses the extent of the disease and any damage to the bladder tissues.
4. Next, they detach the bladder from the surrounding organs, separating attached tissues and ligating blood vessels as necessary.
5. The provider excises the bladder from the surrounding organs and structures.
6. They also perform a bilateral pelvic lymphadenectomy, removing lymph nodes from both sides, including the external iliac, hypogastric, and obturator nodes.
7. One of the ureters is attached to a part of the bowel, and the other end is brought out onto the surface of the body to create a stoma for urine drainage.
8. A catheter is placed for urine drainage into the ureter to prevent leakage and abscess formation.
9. The provider stops any bleeding, places a drain tube, and closes the abdominal wound with sutures.
10. The drainage tube and catheter are typically removed after five days.

4. Qualifying circumstances

CPT 51575 is performed when there is cancer present in multiple areas of the bladder, requiring the complete removal of the bladder. The procedure also includes the removal of bilateral pelvic lymph nodes, specifically the external iliac, hypogastric, and obturator nodes. This surgery is typically performed by a qualified provider who specializes in urological procedures.

5. When to use CPT code 51575

CPT code 51575 should be used when the provider performs a complete cystectomy, removing the entire urinary bladder, along with bilateral pelvic lymphadenectomy. This code is appropriate when there is cancer present in multiple areas of the bladder and the procedure includes the removal of the specified lymph nodes. It is important to accurately document the extent of the disease and the lymph nodes removed to support the use of this code.

6. Documentation requirements

To support a claim for CPT code 51575, the provider must document the following information:

• Patient’s diagnosis and the presence of cancer in multiple areas of the bladder
• Extent of the disease and any damage to the bladder tissues
• Specific lymph nodes removed, including the external iliac, hypogastric, and obturator nodes
• Date of the procedure and duration
• Details of the surgical technique used
• Any complications or additional procedures performed
• Signature of the performing provider

7. Billing guidelines

When billing for CPT code 51575, ensure that the procedure includes the complete removal of the urinary bladder and bilateral pelvic lymphadenectomy, including the specified lymph nodes. It is important to accurately document the extent of the disease and the lymph nodes removed to support the use of this code. Additionally, follow any specific billing guidelines provided by the payer or coding guidelines. It is also important to review any applicable modifiers that may be required for accurate billing.

8. Historical information

CPT code 51575 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 billing purposes.

9. Examples

1. A patient with bladder cancer undergoes a complete cystectomy with bilateral pelvic lymphadenectomy, including the external iliac, hypogastric, and obturator nodes.
2. A provider performs a cystectomy with lymphadenectomy on a patient with advanced bladder cancer, removing the entire bladder and the specified lymph nodes.
3. A patient with bladder cancer undergoes a surgical procedure in which the provider removes the complete urinary bladder and performs a bilateral pelvic lymphadenectomy, including the external iliac, hypogastric, and obturator nodes.
4. A provider performs a cystectomy with lymphadenectomy on a patient with metastatic bladder cancer, removing the bladder and the specified lymph nodes to prevent further spread of the disease.
5. A patient with bladder cancer undergoes a complete removal of the urinary bladder along with bilateral pelvic lymphadenectomy, including the external iliac, hypogastric, and obturator nodes, to treat the disease and prevent its recurrence.
6. A provider performs a cystectomy with lymphadenectomy on a patient with invasive bladder cancer, removing the entire bladder and the specified lymph nodes to improve the patient’s prognosis.
7. A patient with bladder cancer undergoes a surgical procedure in which the provider removes the complete urinary bladder and performs a bilateral pelvic lymphadenectomy, including the external iliac, hypogastric, and obturator nodes, to eliminate the cancerous cells and reduce the risk of metastasis.