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2025 CPT code 50220

Nephrectomy, including partial ureterectomy, any open approach including rib resection.

Adhere to the current CPT coding guidelines for surgical procedures.Accurate documentation of the surgical approach, extent of the resection, and any complications are crucial for proper coding and reimbursement.

Modifiers may be applicable depending on the circumstances of the surgery (e.g., modifier 51 for multiple procedures, modifier 22 for increased procedural services, modifier 59 for distinct procedural service).

Medical necessity for nephrectomy can be established based on the presence of kidney cancer, severe trauma, irreparable kidney damage, significant obstruction of the ureter, or severe infection.Documentation should support the diagnosis and the extent of the disease to justify the surgical intervention.

The physician's responsibilities include making the incision, accessing the kidney (possibly including rib resection), dissecting the ureter and blood vessels, removing the kidney and a portion of the ureter, and closing the incision.Depending on the case, the adrenal gland or other surrounding tissues may also be removed.

IMPORTANT:Use 50225 if the same surgery has been performed on the same kidney previously. Use 50230 for radical nephrectomy (includes removal of kidney, ureter section, adrenal gland, and surrounding fatty tissue, often for kidney cancer). Use 50234 if the nephrectomy included total ureterectomy and bladder cuff removal through the same incision; use 50236 if through separate incisions.Use 50240 for partial nephrectomy (removal of only the diseased portion).

In simple words: This code describes a surgical operation to remove a kidney and a small part of the tube that carries urine from the kidney to the bladder.The surgery might require removing a rib to reach the kidney.

This code encompasses the surgical removal of a kidney (nephrectomy) along with a portion of the ureter (partial ureterectomy).The procedure can be performed via any open approach, which may involve rib resection to access the kidney.The surgical technique involves disconnecting the ureter and blood vessels, removing the kidney and the specified part of the ureter, and then closing the incision.Additional tissues, such as the adrenal gland, might be removed depending on the specific case.

Example 1: A 60-year-old male presents with a large renal cell carcinoma in the upper pole of the right kidney.Open nephrectomy with partial ureterectomy is performed.The surgeon resects a portion of the 12th rib for improved access., A 45-year-old female with a history of kidney stones undergoes open nephrectomy and partial ureterectomy due to a large stone obstructing the ureter and causing severe hydronephrosis.Partial ureterectomy is necessary to facilitate stone removal and prevent future blockages., A 72-year-old male experiences severe trauma to the left kidney in a motor vehicle accident.An open nephrectomy and partial ureterectomy are required due to irreparable kidney damage and the risk of ongoing bleeding.

Complete operative report detailing the surgical approach, the extent of the resection (kidney and ureter), any additional tissue removed (e.g., adrenal gland), and the presence of any complications.Preoperative imaging studies (e.g., CT scan, ultrasound) demonstrating the need for the procedure.Pathology report confirming the diagnosis and the extent of disease.

** The description of this code includes partial ureterectomy, which means only a part of the ureter is removed.The extent of the ureterectomy needs to be carefully documented to ensure accurate coding.This code should not be used if a lymph node dissection was not performed.

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