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Nephrotomy, specifically referred to as an open nephrotomy, is a surgical procedure that involves making an incision in the kidney to allow for internal exploration. This procedure is typically indicated when there is a need to investigate or address various conditions affecting the kidney. The process begins with a skin incision made directly over the kidney, followed by careful dissection of the surrounding soft tissues. In some cases, it may be necessary to remove part of the lower rib(s) to gain adequate access to the kidney. Once the incision is made, Gerota's fascia, which is the connective tissue surrounding the kidney, is incised, and the perirenal fat is meticulously dissected away to expose the kidney. During the procedure, blood vessels are identified and controlled by placing a loop around each vessel to prevent excessive bleeding. The kidney is then fully exposed, allowing for a thorough visual examination. A small incision is made in the kidney itself to facilitate exploration, and the edges of this incision are retracted to provide a clear view of the internal structures. After the exploration is completed, a drainage catheter or tube may be placed through the skin to assist with any necessary drainage, and this is secured in position. The procedure concludes with the closure of Gerota's fascia, the removal of the vessel loops, and the layered closure of the skin incision, ensuring proper healing and minimizing the risk of complications.
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Open nephrotomy is performed for various indications that necessitate direct access to the kidney for exploration and potential intervention. The following conditions may warrant this procedure:
The open nephrotomy procedure involves several critical steps to ensure proper access and exploration of the kidney. The following outlines the procedural steps:
After the open nephrotomy procedure, patients may require monitoring for any complications, such as bleeding or infection. The placement of a drainage catheter may necessitate specific care to ensure it remains patent and functions correctly. Patients are typically advised on activity restrictions during the recovery period to promote healing. Follow-up appointments are essential to assess the surgical site and kidney function, ensuring that any underlying issues are addressed promptly.
| Short Descr | NEPHROTOMY W/EXPLORATION | Medium Descr | NEPHROTOMY W/EXPLORATION | Long Descr | Nephrotomy, with exploration | 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) | 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 | 103 - Nephrotomy and nephrostomy |
| 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). | 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.) | 80 | Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s). | AS | Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery | FS | Split (or shared) evaluation and management visit | 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) |
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| 2023-01-01 | Note | Short description changed. |
| Pre-1990 | Added | Code added. |
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