CPT® Code 50070

Nephrolithotomy is a surgical procedure aimed at the removal of kidney stones, specifically renal calculi, through an open surgical approach. This particular code, CPT® 50070, is designated for cases where the nephrolithotomy is complicated by a congenital kidney abnormality. Congenital kidney abnormalities can include various conditions such as parenchymal disease, congenital obstruction of the ureteropelvic junction, which may or may not be associated with hydronephrosis, and polycystic kidney disease. During the procedure, a skin incision is made over the kidney, allowing the surgeon to access the renal area. The soft tissues surrounding the kidney are carefully dissected, and Gerota's fascia, which is the connective tissue surrounding the kidney, is incised to expose the perirenal fat. Blood vessels in the area are identified and controlled using vessel loops to prevent excessive bleeding. Once the kidney is adequately exposed, the surgeon examines it visually to locate the renal calculus. An incision is then made directly over the calculus to facilitate its removal. The stone is extracted and sent for laboratory analysis, which is reportable separately. Post-removal, drains may be placed as necessary, Gerota's fascia is closed, the vessel loops are removed, and the incision is meticulously closed in layers to promote proper healing.