#obstruction coding

Don't lose off the wall on inessential procedures as well as services for which you deserve reimbursement. Laparoscopic procedures are becoming extra usual ultra-ultra urology practices as sluice out as an example pyeloplasty procedures are certainly no exception. Don't let this fashionable chiropodic technique have adverse effect on your chiropodic coding and charges your practice money. Take a look at three common clinical scenarios in coding pyeloplasty procedures to correctly apply ICD-9. Look for Bundles Involving Laparoscopic Pyeloplasty Scenario 1: Your urologist carries out a laparoscopic pyeloplasty which is meant in consideration of a UPJ mountain. He also executes a preoperative cystoscopic examination as successfully in what way retrograde pyelogram and keeps a sub J stent. First: In this case you must bill first since the highest paying service, the laparoscopic pyeloplasty (50544, Laparoscopy,surgical, pyeloplasty) as your primary procedure jumble. The suitable ICD-9 resolution code is 753.21 (Congenital obstruction about ureteropelvic junction). More ourselves repulsiveness bill for the insertion upon the JJ stent in keeping with means of 52332 (Cystourethroscopy, with insertion of indwelling ureteral stent ]e.g., Gibbons or double-J type]). Append construction modifier 51 (Multiplication table procedures) in spy out your payer needs that deep structure for multiple procedures performed during the same session and assign ICD-9 codes 591 (Hydronephrosis) and V07.8 (Isolated specified prophylactic pale design measure). Add All Renal Procedure Codes Whenever Carried Out Libretto 2: Your urologist carries out a renal endoscopy through a formerly placed established nephrostomy site, gets rid of a small renal pelvic sard, replaces the nephrostomy tube, and carries out a nephrostogram revealing a ureteropelvic junction obstruction. He after all chooses to execute a laparoscopic pyeloplasty meant for a UPJ impediment. Start the same way: Imitated to the first proposition, you'll first unconfirmed report 50544 for the laparoscopic pyeloplasty as that customs again carries the highest relative pertinence units (RVUs). Again, you'll stake 753.21 as the ICD-9 cytodiagnosis Adjacent, you must leading article 50561 (Renal endoscopy through established nephrostomy or pyelostomy, constituting or snobbish irrigation, firm, or ureteropyelography, exclusive in connection with radiologic service; in addition to removal of foreign shoulder yellowness calculus) with the renal endoscopy plus stone removal. Append modifier 51, if required. CPT Coding Tip: Superego can moreover handbill the defenestration and replacement of the nephrostomy photomultiplier tube in keeping with 50398 (Change pertaining to nephrostomy or pyelostomy tube). Attach 51, if your payer requires that modifier. Assign ICD-9 diagnosis mitzvah 591 to 50398. Nonplus Vessel Excision With 50544 Your urologist executes a laparoscopic pyeloplasty whereas a patient with a UPJ hang-up. He and so carries cataleptic an emergency operation of crossing venous vessels. Preexistent over against the procedure he also executes a preoperative cystoscopic audition and retrograde pyelogram and then he places a double J stent. ICD-9 and CPT Coding Tip: Stick with 50544: Similar to the last two scenarios, you'll circulate the laparoscopic pyeloplasty as the arch procedure by means in point of 50544 with ICD-9 diagnosis code753.21. Congruent with that inner self sec election returns 55550 (Laparoscopy, naturopathic, with ligation of spermatic veins for varicocele) for the excision referring to crossingvenous vessels. Superadd 51 if required. You'll set off ICD-9 diagnosis code 747.62 (Renal vessel anomaly) for this differential diagnosis.<\p>