2025 CPT code 50234
(Active) Effective Date: N/A Revision Date: N/A Surgery - Surgical Procedures on the Urinary System Surgery Feed
Nephrectomy with total ureterectomy and bladder cuff excision through a single incision.
Modifiers may be applicable depending on circumstances, such as 50 (bilateral procedure) if both kidneys and ureters are involved, or other modifiers to indicate specific circumstances of the procedure or services provided.
Medical necessity for 50234 is established when a patient has a condition requiring complete removal of the kidney and ureter, potentially involving the bladder cuff (e.g., malignancy, severe infection, trauma).The procedure must be deemed medically appropriate based on the patient's clinical presentation, diagnostic studies, and the anticipated benefits of the surgery. Payer guidelines should be consulted to ensure compliance with specific medical necessity criteria.
The surgical removal of the kidney, ureter, and bladder cuff requires a skilled surgeon experienced in urologic procedures.Pre-operative planning includes imaging studies (CT, MRI) to assess the extent of the tumor and plan the surgical approach. Intra-operative care involves meticulous dissection to avoid damage to surrounding blood vessels and nerves. Post-operative care includes monitoring for complications like bleeding, infection, and urinary leak. The surgeon is responsible for all aspects of the procedure, from pre-operative evaluation to post-operative follow-up.
In simple words: This code describes a surgery where the doctor removes a kidney, the tube that carries urine from the kidney to the bladder (ureter), and a small part of the bladder. All these parts are removed through one cut in the abdomen.This surgery is often done for kidney cancer.
This CPT code, 50234, denotes a nephrectomy (surgical removal of a kidney) performed in conjunction with a total ureterectomy (complete removal of the ureter) and excision of the bladder cuff.All three procedures are conducted through a single incision. This is a complex surgical procedure often undertaken to treat renal cell carcinoma or other conditions requiring complete removal of the kidney and ureter along with the bladder cuff. The procedure involves precise dissection and meticulous surgical technique to ensure complete removal of the affected tissues while minimizing damage to surrounding structures.Post-operative care includes management of urinary drainage via a nephrostomy tube (tube placed in the renal pelvis and connected to the skin).
Example 1: A 65-year-old male patient is diagnosed with renal cell carcinoma involving the right kidney, extending into the ureter and the bladder cuff.A 50234 is appropriate for the surgical removal of the entire affected area through a single incision., A 50-year-old female patient presents with a large retroperitoneal tumor that compresses her right kidney and ureter.The surgeon performs a nephrectomy with total ureterectomy and bladder cuff excision (50234) to remove the tumor and restore normal urinary function.Other codes may be necessary to reflect the resection of the retroperitoneal tumor itself., A 72-year-old patient with a history of bladder cancer undergoes a nephroureterectomy with bladder cuff excision (50234) as part of a comprehensive surgical approach to manage the cancer's recurrence.
Complete and accurate documentation should include the pre-operative diagnosis (with imaging findings such as CT scan or MRI), the surgical approach (open or laparoscopic), the extent of resection, operative findings (e.g., size and location of the tumor, involvement of adjacent organs), pathology report confirming the diagnosis and the extent of the tumor, intra-operative complications, and post-operative course.All documentation should support the medical necessity for the procedure.
** This code should be used carefully and only when all three elements (nephrectomy, total ureterectomy, and bladder cuff excision) are performed through a single incision.Proper documentation and coding are crucial for accurate reimbursement.
- Revenue Code: P1G (MAJOR PROCEDURE - OTHER)
- Payment Status: Active
- Modifier TC rule: The TC modifier (Technical Component) is not applicable to this code as it represents a complete surgical procedure.
- Specialties:Urology, Surgical Oncology
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center