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The procedure described by CPT® Code 51580 involves a complete cystectomy, which is the surgical removal of the entire bladder. This procedure is typically indicated for patients with severe bladder conditions, such as cancer, that necessitate the complete removal of the bladder. Following the cystectomy, a urinary diversion is created, which can be achieved through either a ureterosigmoidostomy or ureterocutaneous transplantation. In a ureterosigmoidostomy, the ureters, which are the tubes that carry urine from the kidneys, are connected to the sigmoid colon, allowing urine to be expelled through the rectum. Alternatively, in a ureterocutaneous transplantation, the ureters are connected to the skin surface, creating a stoma through which urine is drained externally. The procedure is performed using an intraperitoneal approach, which involves making an incision in the midline of the abdomen and carefully dissecting surrounding tissues and lymph nodes to access the bladder and ureters. This complex surgical intervention requires meticulous attention to detail to preserve surrounding structures and ensure proper urinary function post-surgery.
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The complete cystectomy with urinary diversion is indicated for various severe bladder conditions, including:
The procedure for complete cystectomy with ureterosigmoidostomy or ureterocutaneous transplantation involves several detailed steps:
After the completion of the cystectomy and urinary diversion, patients typically require careful monitoring and management. Post-operative care may include pain management, monitoring for signs of infection, and ensuring proper function of the urinary diversion. Patients may need to adapt to changes in urinary function, especially if a stoma has been created. Follow-up appointments are essential to assess recovery and address any complications that may arise. Additionally, education on stoma care and lifestyle adjustments may be necessary for patients who undergo ureterocutaneous transplantation.
| Short Descr | REMOVE BLADDER/REVISE TRACT | Medium Descr | CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES | Long Descr | Cystectomy, complete, with ureterosigmoidostomy or ureterocutaneous transplantations; | Status Code | Active Code | Global Days | 090 - Major Surgery | PC/TC Indicator (26, TC) | 0 - Physician Service Code | Multiple Procedures (51) | 2 - Standard payment adjustment rules for multiple procedures apply. | Bilateral Surgery (50) | 0 - 150% payment adjustment for bilateral procedures does NOT apply. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 2 - Payment restriction for assistants at surgery does not apply to this procedure... | Co-Surgeons (62) | 1 - Co-surgeons could be paid, though supporting documentation is required... | Team Surgery (66) | 0 - Team surgeons not permitted for this procedure. | Diagnostic Imaging Family | 99 - Concept Does Not Apply | APC Status Indicator | Inpatient Procedures, not paid under OPPS | Type of Service (TOS) | 2 - Surgery | Berenson-Eggers TOS (BETOS) | P1G - Major procedure - Other | MUE | 1 | CCS Clinical Classification | 112 - Other OR therapeutic procedures of urinary tract |
| 22 | Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service. | 58 | Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78. | 62 | Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate. | 79 | Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.) | 82 | Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | GC | This service has been performed in part by a resident under the direction of a teaching physician |
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| 2010-01-01 | Changed | Code description changed. |
| Pre-1990 | Added | Code added. |
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