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The CPT® Code 50328 refers to the procedure of backbench reconstruction of a renal allograft, which can be derived from either a cadaver or a living donor, specifically focusing on the arterial anastomosis. This procedure is a critical step in the transplantation process, as it involves the preparation of the renal arteries prior to the actual transplantation of the kidney. During this reconstruction, one or more renal arteries are meticulously reconstructed using the gonadal vein that is harvested along with the kidney. The gonadal vein serves as a valuable resource, allowing for the creation of a patch or graft that is essential for repairing or lengthening a single renal artery when necessary. In cases where multiple renal artery branches are present, the procedure may involve anastomosing these arteries together in a side-to-side configuration to form a single, more functional renal artery. Alternatively, each renal artery may be prepared separately, utilizing a venous graft to ensure proper blood flow post-transplantation. This meticulous surgical technique is vital for ensuring the viability of the transplanted kidney and optimizing its function once implanted into the recipient. The code 50328 is specifically reported for each arterial anastomosis performed during this reconstruction process, highlighting the complexity and precision required in renal transplantation surgeries.
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The procedure described by CPT® Code 50328 is indicated for patients undergoing kidney transplantation, where arterial reconstruction is necessary to ensure proper blood supply to the transplanted renal allograft. The following conditions may warrant this procedure:
The procedure for CPT® Code 50328 involves several critical steps to ensure the successful arterial reconstruction of the renal allograft:
After the completion of the arterial reconstruction procedure, careful monitoring and post-operative care are essential to ensure the success of the transplantation. The patient will typically be observed for any signs of complications, such as bleeding or graft failure. Additionally, the surgical team will assess the blood flow to the transplanted kidney to confirm that the arterial anastomosis is functioning properly. Follow-up imaging studies may be conducted to evaluate the patency of the renal arteries. The overall recovery process will depend on the individual patient's condition and the complexity of the surgery performed.
| Short Descr | PREP RENAL GRAFT/ARTERIAL | Medium Descr | BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA | Long Descr | Backbench reconstruction of cadaver or living donor renal allograft prior to transplantation; arterial anastomosis, each | Status Code | Active Code | Global Days | XXX - Global Concept Does Not Apply | 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 | 104 - Nephrectomy, partial or complete |
| 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). | 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). | GC | This service has been performed in part by a resident under the direction of a teaching physician | 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 | 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. | 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. | 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. | 76 | Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service. | 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.) | LT | Left side (used to identify procedures performed on the left side of the body) | Q1 | Routine clinical service provided in a clinical research study that is in an approved clinical research study | Q3 | Live kidney donor surgery and related services | RT | Right side (used to identify procedures performed on the right side of the body) | XU | Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service |
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| 2005-01-01 | Added | First appearance in code book in 2005. |
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