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Urogenital and Urinary Surgical Procedures

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Urogenital and Urinary Surgical Procedures UROGENITAL AND URINARY SURGICAL PROCEDURES Urogenital and Urinary Surgical ProceduresApril 1, 2015 PREAMBLE - KIDNEY AND UPPER URINARY TRACT 1. No additional claim should be made for nephroscopy when done at the time of pyelolithotomy or nephrolithotomy. This does not apply to nephroscopy done in conjunction with codes listed under "Percutaneous - Procedures." 2. In a routine surgical approach to the kidney and related procedures, no additional claim should be made for rib resection carried out for access purposes. 3. When an adrenalectomy is performed in conjunction with a nephrectomy, and is incidental to the removal of the kidney, there should be no additional claim for the adrenalectomy. April 1, 2015 T1 Amd 12 Draft 1 UROGENITAL AND URINARY SURGICAL PROCEDURES KIDNEY AND UPPER URINARY TRACT Asst Surg Anae # E752 - with repeat surgery on kidney at least 30 days after previous kidney surgery......................................................................................................add 83.25 INCISION # Z601 Renal biopsy, needle ............................................................................................... 143.55 6 # S401 Drainage of kidney abscess..................................................................................... 7 411.30 7 # S402 Drainage of perinephric abscess ............................................................................. 7 267.60 7 # S403 Exploration of renal and peri-renal tissues (with or without biopsy or unroofing of cyst) ................................................................................................................... 7 356.70 7 # E792 - when performed laparoscopically, to S403 .......................................add 25% # S400 Laparoscopic placement of probe(s) for ablation of renal tumour ........................... 7 404.95 7 Payment rules: This service is not eligible for payment in addition to J069. # S405 Nephrolithotomy - open ........................................................................................... 7 482.40 7 # S408 Pyelolithotomy - open .............................................................................................. 7 437.20 7 # S430 Removal of staghorn calculus filling renal pelvis and calyces - open, with or without x-ray control and/or anatrophic nephrolithotomy................................................ 7 657.75 9 EXCISION # S410 Calycectomy with diversion of urine ........................................................................ 7 512.00 7 # S411 Partial or heminephrectomy..................................................................................... 7 875.00 7 # E792 - when performed laparoscopically, to S411 .......................................add 25% # S423 Partial or heminephrectomy with total ureterectomy................................................ 7 757.85 7 Nephrectomy # S412 - ectopic kidney .................................................................................................... 7 467.00 7 # S413 - lumbar ................................................................................................................ 7 467.00 7 # E792 - when performed laparoscopically, to S413 .......................................add 25% # S415 - transperitoneal ................................................................................................... 7 522.50 7 # S416 - thoraco-abdominal or radical nephrectomy........................................................ 9 875.00 13 # E766 - with gland dissection.................................................................................add 29.70 # E767 - with repair of vena cava for thrombus - below the hepatic vein................add 138.15 # E768 - with repair of vena cava for thrombus - above the hepatic vein ...............add 236.70 # E792 - when performed laparoscopically, to S416 .......................................add 25% # S424 Extrophy - plastic closure of bladder with closure of abdominal wall and urethral lengthening with closure of pelvic floor with or without reimplantation of ureters 7 939.70 10 # S420 Nephroureterectomy, total, with resection of ureterovesical junction....................... 7 673.10 10 # E792 - when performed laparoscopically, to S420 .......................................add 25% REPAIR # S422 Pyeloplasty (with or without nephropexy) ................................................................ 7 679.25 7 # E792 - when performed laparoscopically, to S422 .......................................add 25% # E754 - with removal of calculus............................................................................add 57.50 # S428 Symphysiotomy for horseshoe kidney with or without nephropexy and associated procedures ......................................................................................................... 7 437.20 7 SUTURE # S429 Ruptured or lacerated kidney - repair or removal .................................................... 7 437.20 7 EXTRA RENAL PROCEDURES # S431 Excision of retroperitoneal tumour ........................................................................... 7 381.60 7 # S432 Exploration of retroperitoneal tumour ...................................................................... 7 260.85 7 # S433 Sacrococcygeal teratoma ........................................................................................ 6 437.20 6 # Z630 Extracorporeal shock wave lithotripsy ..................................................................... 314.20 6 Amd 12 Draft 1 T2 April 1, 2015 UROGENITAL AND URINARY SURGICAL PROCEDURES KIDNEY AND UPPER URINARY TRACT Asst Surg Anae PERCUTANEOUS PROCEDURES # Z629 Percutaneous nephrostomy..................................................................................... 153.35 6 # Z623 Insertion of stent ...................................................................................................... 95.10 # Z624 Dilatation of tract...................................................................................................... 105.25 # Z625 Selective catheterization of calyces (one or more) .................................................. 52.70 # Z626 Nephroscopy, percutaneous or retrograde .............................................................. 95.95 6 # Z627 Removal of renal calculi........................................................................................... 6 167.85 7 # E759 - if disintegrated by any method, to Z627....................................................add 95.95 # E772 - percutaneous removal of staghorn calculus filling renal pelvis and extending into calyces...............................................................................................add 175.50 # Z636 Endoscopic ureterotomy or pyelotomy .................................................................... 273.25 7 [Commentary: Z636 is eligible for payment when rendered by percutaneous or retrograde route.] # Z637 Percutaneous ablation of calyceal diverticulum to include dilation of communication with calyx and fulguration................................................................................... 262.75 6 # Z600 Change of nephrostomy tube .................................................................................. 44.00 RENAL TRANSPLANTATION PROCEDURES Note: Submit on recipient’s claim. These fees do not include immunosuppressive therapy which is on a fee-for-service basis. # E762 - reconstruction or repair of renal artery done in addition torenal transplantation procedures................................................................................................add 301.05 # S435 Kidney transplant..................................................................................................... 9 1553.15 13 # E769 - team fee (not to be billed when assistant fees are billed).........................add 260.05 # S434 Kidney re-transplant................................................................................................. 9 1858.15 13 # E771 - team fee (not to be billed when assistant fees are billed).........................add 343.40 # S436 Donor nephrectomy - unilateral or bilateral (to include renal perfusion with hypothermia when rendered by surgeon) .......................................................... 7 653.20 8 # E753 - live donor ..................................................................................................add 156.30 # E792 - when performed laparoscopically, to S436 .......................................add 25% Note: For nephrological components - see Diagnostic and Therapeutic Procedures. # S437 Renal autotransplantation........................................................................................ 7 1161.60 10 # Z631 Fine needle aspiration of renal transplant................................................................ 45.15 ENDOSCOPIC PROCEDURES # S470 Cystoscopy with manipulation and/or removal of calculus and retrograde pyelogram if required ........................................................................................................... 240.65 6 # Z638 Endoscopic treatment of vesicoureteral reflux by subureteral injection of agent, unilateral or bilateral........................................................................................... 6 450.00 6 Note: Z606, Z607, Z611, Z617 and Z628 are not eligible for payment with Z638. Cystoscopy and diagnostic Ureteroscopy # Z628 - above intramural ..............................................................................................
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