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The procedure described by CPT® Code 50040 refers to nephrostomy or nephrotomy with drainage, which is a surgical intervention performed to address specific conditions affecting the kidney. This procedure is typically indicated when there is a blockage in the ureter, often caused by kidney stones or tumors, which prevents urine from flowing properly from the kidney to the bladder. Additionally, nephrostomy or nephrotomy may be necessary in cases where the ureter or bladder has sustained injury, leading to urine leakage into the retroperitoneal or peritoneal cavity. Furthermore, this procedure can serve a diagnostic purpose, allowing healthcare providers to assess the anatomy and function of the kidney. The surgical approach involves making a skin incision over the kidney, followed by careful dissection of the surrounding soft tissues to access the kidney. This detailed process ensures that the kidney is adequately exposed for examination and intervention, ultimately facilitating the drainage of urine and alleviating the complications associated with urinary obstruction or leakage.
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Nephrostomy or nephrotomy with drainage is performed under specific clinical circumstances, which include the following:
The procedure for nephrostomy or nephrotomy with drainage involves several critical steps, which are detailed as follows:
After the nephrostomy or nephrotomy with drainage procedure, patients typically require monitoring for any complications, such as bleeding or infection. The drainage catheter will need to be managed carefully to ensure proper urine flow and to prevent blockage. Patients may also need follow-up imaging studies to assess kidney function and the effectiveness of the drainage. Recovery time can vary based on the individual patient's condition and the complexity of the procedure, but appropriate post-operative care is essential for optimal healing and recovery.
| Short Descr | NFROS NFROT W/DRG | Medium Descr | NEPHROSTOMY NEPHROTOMY W/DRAINAGE | Long Descr | Nephrostomy, nephrotomy with drainage | 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) | 1 - 150% payment adjustment for bilateral procedures applies. | Physician Supervisions | 09 - Concept does not apply. | Assistant Surgeon (80, 82) | 1 - Statutory payment restriction for assistants at surgery applies 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) | P5E - Ambulatory procedures - other | MUE | 1 | CCS Clinical Classification | 103 - Nephrotomy and nephrostomy |
| 50 | Bilateral procedure: unless otherwise identified in the listings, bilateral procedures that are performed at the same session, should be identified by adding modifier 50 to the appropriate 5 digit code. note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 51 | Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d). | 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. | 59 | Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25. | 78 | Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.) | GC | This service has been performed in part by a resident under the direction of a teaching physician | LT | Left side (used to identify procedures performed on the left side of the body) | RT | Right side (used to identify procedures performed on the right side of the body) |
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| 2023-01-01 | Note | Short and medium descriptions changed. |
| Pre-1990 | Added | Code added. |
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