2025 CPT code 50328
Effective Date: N/A Surgery - Surgical Procedures on the Urinary System Feed
Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each.
Modifier 22 (Increased Procedural Services) may be appended to 50328 if the arterial anastomosis is significantly more complex than usual, requiring substantially more time and effort, as documented in the operative report.
Medical necessity is established by the need for a kidney transplant, and the backbench work is a necessary component of preparing the donor kidney for transplantation.The medical record should document the recipient's kidney failure and the suitability of the donor kidney.
The provider prepares the allograft under cold preservation solution and uses multiple renal arteries. If the provider obtains the donor organ from a cadaver, they remove the aortic patch to create the renal artery allograft. The provider removes iliac arteries from the cadaver donor and uses them for the allograft. If the provider obtains the donor organ from a living donor, and there is no aortic patch, they join the inferior epigastric artery to the segmental renal artery. After anastomosis, the provider irrigates the vessels with a solution to ensure they are viable.
In simple words: The surgeon prepares a donor kidney artery for transplant, connecting blood vessels under cold storage.If the kidney is from a deceased donor, the surgeon uses attached sections of the main artery. If the kidney is from a living donor, a different artery from the donor is attached.
This procedure involves preparing an arterial allograft from a cadaver or living donor kidney for transplantation. The allograft is prepared under cold preservation solution, using multiple renal arteries. If the donor organ is from a cadaver, the aortic patch is removed to create the renal artery allograft. Iliac arteries are removed from the cadaver donor and used for the allograft. If the donor organ is from a living donor, and there is no aortic patch, the inferior epigastric artery is joined to the segmental renal artery. After anastomosis, the vessels are irrigated with a solution to ensure viability.
Example 1: A cadaver kidney is being prepared for transplantation. The surgeon performs backbench work, including arterial anastomosis, to prepare the renal artery allograft., A living donor kidney is being prepared for transplantation. The surgeon performs backbench work, including joining the inferior epigastric artery to the segmental renal artery., During backbench preparation of a kidney for transplant, two complex microvascular repairs are required on the arterial anastomosis, adding three hours to the procedure.
Documentation should include details of the backbench work performed, including the type of anastomosis, the source of the donor kidney (cadaver or living), any complexities encountered (e.g., microvascular repairs), and the time spent on each procedure.
** Code 50328 is for the arterial anastomosis performed during backbench reconstruction. It is reported for each anastomosis performed. While the backbench codes generally encompass the work involved, modifier 22 may be appropriate in unusually complex cases with extensive additional work, which must be thoroughly documented.This information is current as of December 1, 2024.
- Revenue Code: P1G
- Payment Status: Active
- Specialties:Urology, Transplant Surgery
- Place of Service:Inpatient Hospital, Ambulatory Surgical Center