CPT® Code 50065

Nephrolithotomy is a surgical procedure specifically designed for the removal of a renal calculus, commonly known as a kidney stone. The term "secondary surgical operation" indicates that this procedure is performed after an initial surgery, which may have been unsuccessful or required further intervention. During an open nephrolithotomy, a surgical incision is made in the skin over the kidney, allowing the surgeon to access the renal area directly. The procedure involves careful dissection of the soft tissues surrounding the kidney, including the incision of Gerota's fascia, which is a layer of connective tissue that encases the kidney. The surgeon meticulously identifies and controls blood vessels by placing loops around them to prevent excessive bleeding during the operation. Once the kidney is adequately exposed, a visual examination is conducted to locate the calculus. An incision is then made in the kidney at the site of the stone, allowing for its removal. The calculus is subsequently sent to a laboratory for analysis, which is a separate reportable service. After the stone is extracted, drains may be placed as necessary to facilitate fluid drainage. The procedure concludes with the closure of Gerota's fascia, removal of the vessel loops, and layered closure of the skin incision. It is important to note that CPT® Code 50060 should be used for the primary surgical procedure to remove the renal calculus, while CPT® Code 50065 is designated for this secondary surgical operation.