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Nephrolithotomy is a surgical procedure specifically designed for the removal of large kidney stones, known as staghorn calculi, which can fill the renal pelvis and calyces. This procedure is particularly indicated when the stone is large and complex, often associated with congenital kidney abnormalities. The term "staghorn calculus" refers to a type of kidney stone that has a branching structure, resembling the antlers of a stag, and typically involves the renal pelvis and extends into multiple calyces. The procedure begins with a surgical incision over the kidney, allowing the surgeon to access the renal tissue directly. Through careful dissection of the surrounding soft tissues and identification of blood vessels, the kidney is exposed for examination. An incision is made in the kidney to access the stone, which is then meticulously removed and sent for laboratory analysis. The procedure may involve techniques such as anatrophic nephrolithotomy or anatrophic pyelolithotomy to ensure complete removal of the stone and any fragments. Post-operative care includes the placement of drains as necessary and layered closure of the incision site. This detailed approach is essential for effectively treating patients with significant renal calculi while minimizing complications and ensuring thorough recovery.
© Copyright 2025 Coding Ahead. All rights reserved.
Nephrolithotomy is indicated for the removal of large staghorn calculi that fill the renal pelvis and calyces. The following conditions may warrant this procedure:
The nephrolithotomy procedure involves several critical steps to ensure the successful removal of the staghorn calculus:
Post-procedure care for patients undergoing nephrolithotomy includes monitoring for any complications, managing pain, and ensuring proper recovery. Patients may require drains to facilitate fluid drainage and prevent accumulation. Follow-up appointments are essential to assess kidney function and confirm that all stone fragments have been successfully removed. Patients should be educated on signs of potential complications, such as infection or bleeding, and advised on lifestyle modifications to prevent future stone formation.
| Short Descr | NL RMVL LG STAGHORN CALCULUS | Medium Descr | NEPHROLITHOTOMY RMVL LARGE STAGHORN CALCULUS | Long Descr | Nephrolithotomy; removal of large staghorn calculus filling renal pelvis and calyces (including anatrophic pyelolithotomy) | 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 |
| 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. | 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). | 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). | 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. |