How To Use CPT Code 51580

CPT 51580 describes the complete removal of the urinary bladder and adjoining organs, along with the rerouting of urine through surgical procedures such as ureterosigmoidostomy or ureterocutaneous transplantations. 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 51580?

CPT 51580 can be used to describe the complete removal of the urinary bladder and adjoining organs, along with the rerouting of urine through surgical procedures such as ureterosigmoidostomy or ureterocutaneous transplantations. This code is typically used when bladder cancer is found in multiple areas of the bladder or when cancer has recurred. The procedure involves the removal of the bladder and surrounding organs, followed by the creation of a method for urinary diversion.

2. Official Description

The official description of CPT code 51580 is: ‘Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations.’

3. Procedure

1. The patient is prepped and anesthetized.
2. A Foley catheter is placed in the urethra and inflated with sterile saline.
3. An incision is made from the navel to the pubic bone, entering the peritoneal cavity.
4. The bladder and surrounding organs are exposed and examined to assess the extent of the disease.
5. All attached tissues are retracted, and the entire bladder and surrounding organs are excised.
6. In female patients, the uterus, ovaries, fallopian tubes, and possibly part of the vagina are removed. In male patients, the prostate, seminal vesicles, and possibly the vas deferens are typically taken.
7. A method of urinary diversion is created, such as implanting a ureter into the colon or joining the urethra to the skin.
8. The incisions are closed, and a drainage tube and catheter are inserted.

4. Qualifying circumstances

CPT 51580 is performed when there is a need for complete cystectomy, typically due to bladder cancer found in multiple areas or recurrent cancer. The procedure involves the removal of the bladder and adjoining organs, along with the rerouting of urine through surgical methods such as ureterosigmoidostomy or ureterocutaneous transplantations.

5. When to use CPT code 51580

CPT code 51580 should be used when a complete cystectomy is performed, along with ureterosigmoidostomy or ureterocutaneous transplantations. It is important to ensure that the procedure meets the specific criteria outlined in the code description. This code should not be used for partial cystectomies or other procedures that do not involve the complete removal of the bladder and adjoining organs.

6. Documentation requirements

To support a claim for CPT 51580, the following documentation is required:

• Patient’s diagnosis and the need for complete cystectomy
• Details of the surgical procedure performed, including the specific methods of urinary diversion used
• Date of the procedure
• Any additional findings or complications encountered during the surgery
• Post-operative care instructions and follow-up plans
• Signature of the performing provider

7. Billing guidelines

When billing for CPT 51580, ensure that the procedure meets the specific criteria outlined in the code description. It is important to accurately document the details of the surgery and provide any necessary supporting documentation. CPT code 51580 should not be reported with other codes that describe partial cystectomies or different methods of urinary diversion.

8. Historical information

CPT 51580 was added to the Current Procedural Terminology system on January 1, 1990. The code has undergone changes, including a code change on January 1, 2010, and being added to the Inpatient Only (IPO) list for Medicare in 2017.

9. Examples

1. A patient undergoes a complete cystectomy with ureterosigmoidostomy due to bladder cancer found in multiple areas.
2. A surgical team performs a cystectomy with ureterocutaneous transplantation to treat recurrent bladder cancer.
3. A patient with bladder cancer undergoes a complete cystectomy with ureterosigmoidostomy and subsequent urinary diversion.
4. A complete cystectomy with ureterocutaneous transplantation is performed on a patient with advanced bladder cancer.
5. A surgical procedure involves a complete cystectomy with ureterosigmoidostomy and the creation of a continent urinary diversion.
6. A patient undergoes a cystectomy with ureterocutaneous transplantation and the rerouting of urine to the skin due to recurrent bladder cancer.
7. A complete cystectomy with ureterosigmoidostomy is performed on a patient with bladder cancer found in multiple areas.
8. A surgical team performs a cystectomy with ureterocutaneous transplantation to treat recurrent bladder cancer.
9. A patient with bladder cancer undergoes a complete cystectomy with ureterosigmoidostomy and subsequent urinary diversion.
10. A complete cystectomy with ureterocutaneous transplantation is performed on a patient with advanced bladder cancer.